SIR 2024
Office-based Procedures
Satya K. Morar, MHM (he/him/his)
Medical Student
Case Western Reserve University School of Medicine
Financial relationships: Full list of relationships is listed on the CME information page.
Rayan Abboud, MD, MS
Integrated IR Resident
Cleveland Clinic Foundation
Disclosure information not submitted.
Basem Abdelmalak, MD
Staff Anesthesiologist
Cleveland Clinic Foundation
Disclosure information not submitted.
Charles Martin, III, MD, MBA, FSIR (he/him/his)
Staff Physician
Cleveland Clinic Foundation
Financial relationships: Full list of relationships is listed on the CME information page.
In other fields, NORA research guides administration, planning, training and education, patient flow, quality assessment, etc.{3} No well-known guides exist in IR. The American Society of Anesthesiologists outlined minimal prerequisites for NORA facilities, which can serve to establish optimized workspace, workflow, and practice development within IR.{4} In IR, frequent techniques include local or general anesthesia, anxiolytics, opioids, and epidural anesthesia.{5} NORA has applications in select IR procedures, such as phrenic nerve blocks for CT-guided pulmonary biopsies.{6} IRs should be familiar with NORA options for patients. and indications (i.e. cost-effective and more appropriate for older patients with comorbidities.{7,8}) Monitored anesthesia, discharge criteria, equipment, suite origination, economic efficiency, regulatory compliance, and personnel are considerations for NORA implementation. Past facilities have been associated with less efficient anesthesia operations, critical in the OBL setting where optimization is paramount.{9} An example is inadequate pain control, one of the most common minor adverse events, as patients leave the same day after a procedure.{10}
Conclusion and/or Teaching Points: NORA as an entity is well-defined, planned for in other specialties, and should be known by IRs. Knowledge of NORA is salient as OBLs become more prevalent and diverse in procedures. These practices should be organized with NORA workflow in mind to optimize patient outcomes.