Anaesthetic practices in non-operating room settings for paediatric patients: A prospective observational study

Background and Aims: Non-operating room anaesthesia (NORA) for paediatric patients presents unique challenges due to the need for sedation or general anaesthesia in settings such as imaging suites and interventional radiology. This study aims to comprehensively examine anaesthetic practices, incidence of adverse events, and associated risk factors in paediatric NORA. Methods: Following institutional ethics committee approval and registration with the Clinical Trials Registry-India, this prospective observational study was conducted over 2 years at a tertiary cancer care centre in India. The study included procedures in radiotherapy, radiology suites, and magnetic resonance imaging (MRI) suites. Data on demographics, procedure details, anaesthesia management, and adverse events were collected. Univariate and multivariate analyses were conducted to identify independent factors associated with increased morbidity. Results: During the 2-year study period, 917 children underwent 3631 procedures in non-operating room settings. There were 221 adverse events in 117 patients. The incidence rate of patients experiencing at least one adverse event leading to morbidity was 3.22%. In multivariate regression analysis, emergency procedures, the site (abdomen), and location (MRI and radiology suite) of the procedures were found to be associated with increased morbidity. Conclusion: Emergency status, NORA location, and site of procedure were identified as significant predictors of adverse events in our study. These findings will help develop targeted protocols and enhance staffing patterns at various NORA locations, ultimately improving patient outcomes.