Pediatric Non-Operating Room Anesthesia in Saudi Arabia: Practices, Resources, and Reported Post-Procedural Complications: A Cross-Sectional Survey.

Background: The use of pediatric non-operating room anesthesia (NORA) has increased substantially, yet information regarding current practices in Saudi Arabia remains limited. This study assessed pediatric NORA practices, resources, and reported complications among anesthesiologists in Saudi Arabia. Methods: A cross-sectional online survey was conducted among anesthesiologists practicing in Saudi Arabia. The questionnaire collected information on participant characteristics, indications for pediatric NORA, patient selection criteria, staffing patterns, infrastructure and equipment availability, anesthetic and monitoring practices, recovery arrangements, and post-procedural complications. Results: A total of 234 anesthesiologists participated. Magnetic resonance imaging (97.9%) and computed tomography (85.5%) were the most common indications. Most participants accepted patients with American Society of Anesthesiologists physical status I-III (65.8%) and reported no age restrictions (62.8%). Hospital infrastructure was considered appropriate by 85.0% of respondents. Pulse oximetry (99.6%), electrocardiography (93.2%), capnography (91.5%), and noninvasive blood pressure monitoring (89.7%) were widely used. General anesthesia (80.8%) and deep sedation (70.1%) were the most frequently used techniques. Propofol (88.9%), midazolam (82.5%), and ketamine (73.9%) were the most used sedative agents. Recovery most frequently occurred in dedicated recovery rooms (88.9%). The complications most frequently reported by respondents were delayed recovery (35.5%), agitation or delirium (27.4%), cough (21.8%), and nausea or vomiting (17.5%). Conclusions: Pediatric NORA in Saudi Arabia is commonly performed for imaging procedures and is generally supported by appropriate infrastructure and monitoring practices. Nevertheless, variations in resource availability highlight opportunities for further standardization and quality improvement.