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Chapter 15 - Total Intravenous Anaesthesia

Published online by Cambridge University Press:  18 August 2022

By
Scott Miller
Edited by
Daniel Rodger ,
Kevin Henshaw ,
Paul Rawling  and
Scott Miller
Daniel Rodger
Affiliation:
Senior Lecturer in Perioperative Practice, London South Bank University
Kevin Henshaw
Affiliation:
Associate Head of Allied Health Professions, Edge Hill University, Ormskirk
Paul Rawling
Affiliation:
Senior Lecturer in Perioperative Practice, Edge Hill University, Ormskirk
Scott Miller
Affiliation:
Consultant Anaesthetist, St Helens and Knowsley Hospitals NHS Trust
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Summary

Since initial experiments with nitrous oxide and ether in the nineteenth century, general anaesthesia has been near synonymous with inhaled agents. However, total intravenous anaesthesia may offer advantages in certain circumstances. Total intravenous anaesthesia can be defined as the induction and maintenance of general anaesthesia using agents given solely intravenously and in the absence of all inhalational agents including nitrous oxide. It may be necessary when volatile anaesthesia is contraindicated or infeasible or may be chosen for other benefits. This chapter provides an overview of the benefits and disadvantages of total intravenous anaesthesia, as well as describing the equipment and care required to use it safely.

Keywords

TIVAAnalgesiaAwarenessAnaesthesiaIntravenousInfusionPropofolRemifentanilInductionEmergence
Type
Chapter
Information
Fundamentals of Operating Department Practice , pp. 164 - 171
Publisher: Cambridge University Press
Print publication year: 2022

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References

Kumar, G., Stendall, C., Mistry, R., et al. A comparison of total intravenous anaesthesia using propofol with sevoflurane or desflurane in ambulatory surgery: systematic review and meta-analysis. Anaesthesia 2014; 69: 1138–1150.Google Scholar
Charlesworth, M. and Swinton, F.. Anaesthetic gases, climate change, and sustainable practice. Lancet Planet Health 2017; 1: e216–e217.CrossRefGoogle ScholarPubMed
Lumb, A. B. and Slinger, P.. Hypoxic pulmonary vasoconstriction: physiology and anesthetic implications. Anesthesiology 2015; 122: 932–946.Google Scholar
Preethi, J., Bidkar, P. U., Cherian, A., et al. Comparison of total intravenous anesthesia vs. inhalational anesthesia on brain relaxation, intracranial pressure, and hemodynamics in patients with acute subdural hematoma undergoing emergency craniotomy: a randomized control trial. European Journal of Trauma and Emergency Surgery 2021; 47: 831–837.Google Scholar
Wigmore, T. J., Mohammed, K., and Jhanji, S.. Long-term survival for patients undergoing volatile versus IV anesthesia for cancer surgery: a retrospective analysis. Anesthesiology 2016; 124: 69–79.Google Scholar
Gupta, P. K. and Hopkins, P. M.. Diagnosis and management of malignant hyperthermia. BJA Education 2017; 17: 249–254.Google Scholar
Booker, P. D., Whyte, S. D., and Ladusans, E. J.. Long QT syndrome and anaesthesia. British Journal of Anaesthesia 2003; 90: 349–366.Google Scholar
Santonocito, C., Noto, A., Crimi, C., et al. Remifentanil-induced postoperative hyperalgesia: current perspectives on mechanisms and therapeutic strategies. Local and Regional Anesthesia 2018; 11:15–23.Google Scholar
Pandit, J. J., Andrade, J., Bogod, D. G., et al. 5th National Audit Project (NAP5) on accidental awareness during general anaesthesia: summary of main findings and risk factors. British Journal of Anaesthesia 2014; 113: 549–559.CrossRefGoogle Scholar
Wong, J. M.. Propofol infusion syndrome. American Journal of Therapeutics 2010; 17: 487–491.Google Scholar
Medicines and Healthcare products Regulatory Agency. Intravenous (IV) extension sets with multiple ports: risk of backtracking. Available from: www.gov.uk/drug-device-alerts/medical-device-alert-intravenous-iv-extension-sets-with-multiple-ports-risk-of-backtracking.Google Scholar
Mertes, P. M., Malinovsky, J. M., Jouffroy, L., et al. Reducing the risk of anaphylaxis during anesthesia: 2011 updated guidelines for clinical practice. Journal of Investigational Allergology and Clinical Immunology 2011; 21: 442–453.Google Scholar
Yu, E. H., Tran, D. H., Lam, S. W., and Irwin, M. G.. Remifentanil tolerance and hyperalgesia: short-term gain, long-term pain? Anaesthesia 2016; 71: 1347–1362.Google Scholar

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