Total intravenous anaesthesia: Difference between revisions

Latest revision as of 00:58, 18 February 2025

Anesthesia technique using intravenous drugs

Total intravenous anaesthesia (TIVA) is a method of inducing and maintaining general anesthesia exclusively through the administration of intravenous drugs, without the use of inhalation agents. This technique is often employed in various surgical procedures and is known for its ability to provide a stable and controlled anesthetic state.

Technique[edit]

TIVA involves the continuous infusion of anesthetic drugs through an infusion pump. The most commonly used drugs in TIVA include propofol, remifentanil, and other opioids. These drugs are administered in a carefully controlled manner to maintain the desired depth of anesthesia.

The administration of TIVA requires precise monitoring of the patient's physiological parameters, including heart rate, blood pressure, and oxygen saturation. An important aspect of TIVA is the use of bispectral index (BIS) monitoring or other forms of electroencephalography (EEG) to assess the depth of anesthesia.

Advantages[edit]

TIVA offers several advantages over traditional inhalation anesthesia. It provides a more predictable and rapid recovery, as the drugs used have a short half-life and are quickly metabolized. This can lead to reduced postoperative nausea and vomiting, which is a common side effect of inhalation agents.

Additionally, TIVA is beneficial in patients with a history of malignant hyperthermia, a rare but serious reaction to certain anesthetic gases. Since TIVA does not use inhalation agents, it eliminates the risk of triggering this condition.

Disadvantages[edit]

Despite its benefits, TIVA also has some disadvantages. The technique requires sophisticated equipment and careful monitoring, which can increase the complexity and cost of anesthesia management. Furthermore, the lack of inhalation agents means that there is no direct measurement of anesthetic concentration, making it crucial to rely on indirect measures such as BIS monitoring.

Applications[edit]

TIVA is widely used in various surgical settings, including day surgery, neurosurgery, and cardiac surgery. It is particularly useful in procedures where rapid recovery and minimal postoperative side effects are desired.

Related pages[edit]

Infusion pump used in total intravenous anaesthesia
EEG recording cap used in total intravenous anaesthesia

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-'''Total Intravenous Anaesthesia (TIVA)''' is a technique of [[anesthesia]] that involves the exclusive use of [[intravenous]] drugs to induce and maintain general [[anesthesia]] without the use of [[inhalational anaesthetics]]. TIVA is commonly used for surgeries where maintaining a stable respiratory and cardiovascular system is crucial, and for patients where inhalational anaesthetics are contraindicated.
+{{Short description|Anesthesia technique using intravenous drugs}}
+{{Use dmy dates|date=October 2023}}
-==Indications==
+'''Total intravenous anaesthesia''' ('''TIVA''') is a method of inducing and maintaining general anesthesia exclusively through the administration of intravenous drugs, without the use of inhalation agents. This technique is often employed in various surgical procedures and is known for its ability to provide a stable and controlled anesthetic state.
-TIVA is indicated in a variety of surgical procedures, particularly those involving the [[airway]], such as [[ENT surgery]], and in patients where the use of gas anaesthetics might increase the risk of complications, such as those with a history of malignant [[hyperthermia]]. It is also preferred in procedures where minimal post-operative nausea and vomiting (PONV) is desired and in situations where the precise control of the anaesthetic depth is required, such as [[neurosurgery]].
-==Drugs Used==
+==Technique==
-The most commonly used drugs for TIVA include [[propofol]], which is used for induction and maintenance of anesthesia, and [[opioids]] such as [[remifentanil]] or [[fentanyl]] for analgesia. [[Benzodiazepines]] may also be used for their anxiolytic and amnesic properties. The choice of drugs and their dosages depends on the patient's health, the duration of the surgery, and the specific requirements of the procedure.
+TIVA involves the continuous infusion of anesthetic drugs through an [[infusion pump]]. The most commonly used drugs in TIVA include [[propofol]], [[remifentanil]], and other [[opioids]]. These drugs are administered in a carefully controlled manner to maintain the desired depth of anesthesia.
+[[File:Infusion_pump_2.jpg|thumb|right|An infusion pump used for administering intravenous drugs.]]
+The administration of TIVA requires precise monitoring of the patient's physiological parameters, including [[heart rate]], [[blood pressure]], and [[oxygen saturation]]. An important aspect of TIVA is the use of [[bispectral index]] (BIS) monitoring or other forms of [[electroencephalography]] (EEG) to assess the depth of anesthesia.
+[[File:EEG_Recording_Cap.jpg|thumb|right|An EEG recording cap used for monitoring brain activity during anesthesia.]]
 ==Advantages==
-TIVA has several advantages over inhalational anaesthesia, including a lower risk of PONV, faster recovery times, and less impact on the environment due to the absence of greenhouse gas emissions. It also allows for a more stable hemodynamic profile during surgery and reduces the risk of airway irritation.
+TIVA offers several advantages over traditional inhalation anesthesia. It provides a more predictable and rapid recovery, as the drugs used have a short half-life and are quickly metabolized. This can lead to reduced postoperative nausea and vomiting, which is a common side effect of inhalation agents.
+Additionally, TIVA is beneficial in patients with a history of [[malignant hyperthermia]], a rare but serious reaction to certain anesthetic gases. Since TIVA does not use inhalation agents, it eliminates the risk of triggering this condition.
 ==Disadvantages==
-However, TIVA requires sophisticated infusion devices and continuous monitoring of the patient's depth of anesthesia, which can be challenging. There is also a risk of awareness during surgery if the anesthesia is inadequately managed. Additionally, the lack of a gas mixture means that TIVA cannot be used to manage the patient's ventilation.
+Despite its benefits, TIVA also has some disadvantages. The technique requires sophisticated equipment and careful monitoring, which can increase the complexity and cost of anesthesia management. Furthermore, the lack of inhalation agents means that there is no direct measurement of anesthetic concentration, making it crucial to rely on indirect measures such as BIS monitoring.
-==Techniques==
-The administration of TIVA typically involves the use of programmable infusion pumps that allow for the continuous and controlled delivery of anaesthetic agents. The [[Target-Controlled Infusion (TCI)]] technique is often used, where the infusion rate is adjusted based on the desired target concentration of the drug in the patient's brain.
-==Monitoring==
+==Applications==
-Monitoring during TIVA is critical and includes standard anesthesia monitoring protocols such as [[electrocardiogram]] (ECG), blood pressure, and oxygen saturation. Additionally, the depth of anesthesia is often monitored using [[bispectral index]] (BIS) or similar neurophysiological monitoring techniques to ensure the patient remains unconscious and does not experience awareness during the procedure.
+TIVA is widely used in various surgical settings, including [[day surgery]], [[neurosurgery]], and [[cardiac surgery]]. It is particularly useful in procedures where rapid recovery and minimal postoperative side effects are desired.
-==Conclusion==
+==Related pages==
-Total Intravenous Anaesthesia is a versatile and effective method for inducing and maintaining general anesthesia, particularly suited to certain patient groups and surgical procedures. Its success relies on the careful selection of drugs, sophisticated infusion systems, and diligent monitoring of the patient throughout the surgical process.
+* [[Anesthesia]]
+* [[Propofol]]
+* [[Remifentanil]]
+* [[Malignant hyperthermia]]
 [[Category:Anesthesia]]
-[[Category:Surgical Procedures]]
+<gallery>
-{{surgery-stub}}
+File:Infusion_pump_2.jpg|Infusion pump used in total intravenous anaesthesia
+File:EEG_Recording_Cap.jpg|EEG recording cap used in total intravenous anaesthesia
+</gallery>