Nonoperating room anesthesia for patients with serious comorbidities

Curr Opin Anaesthesiol. 2020 Aug;33(4):594-600. doi: 10.1097/ACO.0000000000000890.

Abstract

Purpose of review: To provide aids to deal with increasing amount of several comorbidities in nonoperating room anesthesia (NORA).

Recent findings: New indexes for assessment of comorbidities are described and guidelines for the care of patients with obesity, obstructive sleep apnea, chronic obstructive pulmonary disease (COPD), diabetes and COVID19 in NORA summarized.

Summary: In addition to ASA classification, such instruments as Charlson Comorbidity Index, Frailty Index, Surgical Complexity Score and Revised Cardiac Risk could supplement the prospective assessment of the risk of comorbidities. Using institutional protocols patients with significant obesity, obstructive sleep apnea, COPD, diabetes and COVID19 can be safely cared in NORA. However, the individual functioning and the severity are more important than only the number of diseases.

Publication types

  • Review

MeSH terms

  • Anesthesia / standards*
  • Anesthesiology / standards*
  • Betacoronavirus
  • COVID-19
  • Comorbidity*
  • Coronavirus Infections
  • Diabetes Mellitus
  • Humans
  • Obesity
  • Pandemics
  • Pneumonia, Viral
  • Practice Guidelines as Topic
  • Prospective Studies
  • Pulmonary Disease, Chronic Obstructive
  • SARS-CoV-2
  • Sleep Apnea, Obstructive