Peri-Procedural Adverse Events in Non-Operating Room Anaesthesia: A Retrospective Case Series from a Tertiary Centre in Eastern India

Dr. Shikta Mishra, Dr. Deepinder Kaur

Abstract: Background: Non-operating room anaesthesia (NORA) is increasingly used for endoscopic, bronchoscopic, interventional radiology and imaging procedures, where remote locations and limited airway access may increase peri-procedural risk. This study describes the pattern, management and immediate outcomes of clinically significant adverse events during NORA at a tertiary centre in Eastern India. Methods: This retrospective review screened all NORA procedures from June to October 2025. Anaesthesia, procedure and recovery records were assessed to identify cases with predefined respiratory, haemodynamic or sedation-related adverse events. Procedures without events and those conducted under general anaesthesia in operating theatres were excluded. Data on demographics, comorbidities, procedure type, anaesthetic technique, adverse events, interventions and outcomes were collected and summarised descriptively. Results: Nine patients met inclusion criteria (mean age 49.7 years; five males, four females; ASA II = 5, ASA III = 4). Procedures included ERCP (n = 4), bronchoscopy (n = 2), interventional radiology (n = 2) and paediatric MRI sedation (n = 1). Eleven adverse events were documented. Respiratory events occurred in six patients (hypoxaemia, bronchospasm, difficult mask ventilation). Haemodynamic events occurred in three (propofol-related hypotension, transient ventricular bigeminy), and sedation-related events in two (paradoxical agitation, delayed recovery). All events were promptly recognised and managed without unplanned intubation, conversion to general anaesthesia, intensive care transfer or mortality. Conclusion: Respiratory and haemodynamic instability were the predominant complications during NORA, but all were reversible with timely intervention. Vigilant monitoring, cautious sedation titration and immediate access to airway and cardiovascular rescue measures are essential for safe NORA practice.

Keywords: Non-Operating Room Anaesthesia, Conscious Sedation, Remote Anaesthesia, Adverse Events, Airway Management

How to Cite?: Dr. Shikta Mishra, Dr. Deepinder Kaur, "Peri-Procedural Adverse Events in Non-Operating Room Anaesthesia: A Retrospective Case Series from a Tertiary Centre in Eastern India", Volume 14 Issue 12, December 2025, International Journal of Science and Research (IJSR), Pages: 254-256, https://www.ijsr.net/getabstract.php?paperid=SR251203223034, DOI: https://dx.doi.org/10.21275/SR251203223034