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.

The choice of the anesthetic technique in austere environments is dictated by the availability of medical personnel, electricity, oxygen, and supplies. TIVA appears to be a very promising, reliable alternative for the future of field anesthesia given its safety, simplicity, rapid setup, and small logistical footprint. Therefore, more anesthesia providers need to be trained and educated to be familiar and comfortable with administration of TIVA. Whenever regional nerve block anesthesia use is appropriate, it can be another excellent choice to provide better acute pain control and decrease postoperative complications in austere environments. There is no perfect analgesic, and hence multimodal approach for pain management is imperative. Early pain treatment has been proven to decrease chronicity, improve functionality, and reduce the risk of subsequent development psychological morbidities such as PTSD and depression. The chapter lists the recommendations on prevention and management of the consequences of sexual violence, reduction of HIV transmission, prevention of excess maternal and neonatal mortality and morbidity, and planning of comprehensive reproductive health services in the early days and weeks of an emergency.