Authors: Bischof et al.
Journal: Current Opinion in Anesthesiology published: April 27, 2026
Summary:
This review article discusses how enhanced recovery after surgery principles could be applied to the nonoperating room anesthesia environment. Enhanced recovery after surgery has become an established approach in many surgical specialties, but similar structured recovery pathways are not yet well developed for patients receiving anesthesia outside the operating room.
The authors note that nonoperating room anesthesia has expanded rapidly because of growth in minimally invasive, catheter-based, endoscopic, interventional radiology, and cardiology procedures. These cases can involve complex patients and significant anesthesia risk, but they often occur in environments that may not have the same standardized perioperative systems as the operating room.
Current evidence for enhanced recovery principles in nonoperating room anesthesia is limited and inconsistent. Most available data come from areas such as gastroenterology, cardiology, and interventional radiology. Some studies suggest that selected enhanced recovery strategies may improve patient comfort, recovery, safety, and procedural efficiency. However, implementation is often fragmented and does not usually follow a complete pathway-based model.
The authors argue that the main problem is not the absence of individual enhanced recovery elements, but the lack of structured recovery governance for nonoperating room anesthesia. In other words, NORA needs organized, multidisciplinary pathways similar to surgical enhanced recovery programs.
Why this matters:
This article is important because NORA continues to grow, and many of these patients are older, sicker, or undergoing increasingly complex procedures. Applying enhanced recovery concepts could help standardize care, improve recovery, improve safety, and increase procedural efficiency.
Take-home point:
Enhanced recovery principles may be useful in the nonoperating room anesthesia environment, but the field needs structured, multidisciplinary, procedure-specific recovery pathways and better clinical and economic outcome data.
Thank you to Current Opinion in Anesthesiology for publishing this article and allowing us to summarize it.