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Out of Operating Room Anesthesia pp 37–50Cite as

Principles of Delivery of Sedatives and Intravenous Anesthetics in Out of Operating Room Anesthesia

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Abstract

Safe and effective delivery of IV sedatives and anesthetics for Out of Operating Room Anesthesia (OORA) is based on the same principles that govern delivery of these medications in the OR settings, while taking into account the unique conditions imposed by the diverse environments of each of the procedural locations. This entails understanding, and implementing, all applicable scientific, technological, regulatory, and organizational principles in order to enhance patient safety and operational efficiency. Delivering OORA poses physical and operational constraints, in the forms of limited lighting; excessive noise; limited access by the clinician to the patient; and limited devise allowance into OORA sites, e.g., MRI suite; disorganized scheduling and inadequate patient preparation.

The benefits of understanding operational principles of OORA extend to OR and ICU settings as many OR suites are becoming increasingly hybrid environments, e.g., OR MRI or OR-bi-plane angiography, and OR electrophysiology; and as many procedures are performed in ICU settings, e.g., percutaneous tracheotomy tube insertion and percutaneous endoscopic gastrostomy (PEG) tube insertions. The portability and versatility of IV anesthetics and sedatives make them particularly suitable choices for OORA. Technological advances in drug delivery of IV anesthetic and sedatives, in the forms of programmable drug delivery devices, and target-controlled infusion (TCI) systems, enhance the utility of IV anesthetics and sedatives in the OORA environment and extends as well to the OR and intensive care units (ICU).

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Author information

Authors and Affiliations

  1. Department of Anesthesiology, Yale University School of Medicine, 333 Cedar Street, TMP 3, New Haven, CT, 06510, USA

    Jean Gabriel Charchaflieh MD, PhD

  2. Department of Anesthesiology, Yale New Haven Hospital, 333 Cedar Street, TMP 3, 208051, New Haven, CT, USA

    Monica Ganatra MD, MPH & Erin Springer MD

Authors
  1. Jean Gabriel Charchaflieh MD, PhD
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  2. Monica Ganatra MD, MPH
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  3. Erin Springer MD
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Corresponding author

Correspondence to Jean Gabriel Charchaflieh MD, PhD .

Editor information

Editors and Affiliations

  1. Associate Professor of Anesthesiology and Critical Care Medicine Perelman School of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA

    Basavana G. Goudra

  2. All India Inst. Med. Sci. (AIIMS), New Delhi, Delhi, India

    Preet Mohinder Singh

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Charchaflieh, J.G., Ganatra, M., Springer, E. (2017). Principles of Delivery of Sedatives and Intravenous Anesthetics in Out of Operating Room Anesthesia. In: Goudra, B.G., Singh, P.M. (eds) Out of Operating Room Anesthesia. Springer, Cham. https://doi.org/10.1007/978-3-319-39150-2_3

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  • DOI: https://doi.org/10.1007/978-3-319-39150-2_3

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-39148-9

  • Online ISBN: 978-3-319-39150-2

  • eBook Packages: MedicineMedicine (R0)

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