Perioperative Pain Management in Non-Operating Room Anesthesia (NORA) Settings

Curr Pain Headache Rep. 2026 Feb 5;30(1):28. doi: 10.1007/s11916-025-01440-w.

ABSTRACT

PURPOSE: The purpose of this review is to present an updated overview of the literature concerning the safe and effective management of perioperative pain in NORA settings. The increasing demand for minimally invasive procedures, driven by advancements in technology, has led to the growing utilization of non-operating room anesthesia (NORA) across multiple medical disciplines.

RECENT FINDINGS: Despite the growing utilization, there is a notable dearth of literature regarding the outcomes of NORA cases, particularly regarding pain management. NORA environments, such as bronchoscopy suites, magnetic resonance imaging (MRI) facilities, interventional cardiology suites, and gastrointestinal (GI) endoscopic units managing conditions like masses, cancers, and bleeding, present distinct challenges for effective pain control. Anesthesiology providers must exhibit adept familiarity and attentiveness, and be vigilant and prepared for diverse NORA settings, some of which may suffer from understaffing, inadequate infrastructure, or remote accessibility, potentially compromising patient outcomes. Further investigation into pain management strategies for NORA patients is imperative. The adaptation and progression of pain services within the dynamic healthcare landscape of NORA, characterized by continual evolution and shifting paradigms, are essential to meet the evolving demands of patient care effectively.

PMID:41642390 | DOI:10.1007/s11916-025-01440-w