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Total intravenous anesthesia (TIVA)

Total intravenous anesthesia with Space®plus

TIVA is a technique of general anesthesia which uses a combination of agents given via syringe pump exclusively by the intravenous route without the use of inhalation agents (Gas Anesthesia).There is a solid rationale for the use of TIVA in some patient cases where the delivery of inhaled anesthetics is impossible or disadvantageous, or in scenarios where traditional anesthetic delivery systems may be unavailable or impractical. In other cases, the use of TIVA could make the process more efficient and advantageous for the patient.

Spaceplus Perfusor
Green figures are depicted, each representing a different organ. One figure has a heart, another has a brain, a third has a liver, and the last one has kidneys.
TCI model

Inhalational anesthesia

is typically applied through tracheal or laryngeal tubes. These are connected to an anesthetic vaporizer and an anesthesia machine. Typical agents are isoflurane, sevoflurane and desflurane. 

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TIVA

Total intravenous anesthesia (TIVA) is a technique of general anesthesia which uses a combination of agents given via syringe pump exclusively by the intravenous route without the use of inhalation agents (Gas Anesthesia).2

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TCI

Target Controlled Infusion (TCI)3 is an algorithm based userfriendly technique for the caregiver. It is the clinical application of pharmacologic models to support the infusion of (anesthesiologic) drugs.

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References

  1. Total Intravenous Anesthesia using a target controlled infusion – A pocket reference’, College of Anesthesiologists, Academy of Medicine Malaysia (retrieved 07.10.15).
  2. Wang Y., Yan M., He J.G., Zhu Y.M., Hu X.S., Li X., Wu W.D. (2011). A randomized comparison of target-controlled infusion of remifentanil and propofol with desflurane and fentanyl for laryngeal surgery, ORL J Otorhinolaryngol Relat Spec., 73(1):47-52.
  3. Ozkose, Z., Ercan, B., Ünal, Y., Yardim, S., Kaymaz, M., Dogulu, F., & Pasaoglu, A. (2001). Inhalation versus total intravenous anesthesia for lumbar disc herniation: comparison of hemodynamic effects, recovery characteristics, and cost. Journal of neurosurgical anesthesiology, 13(4), 296-302.
  4. Lee W.-K., Kim M.-S., Kang S.-W., Kim S., Lee J.-R. (2015). Type of anaesthesia and patient quality of recovery: a randomized trial comparing propofol–remifentanil total i.v. anaesthesia with desflurane anaesthesia, BJA: British Journal of Anaesthesia, 114(4):663–668.
  5. Godet G., Watremez Ch., El Kettani C., Soriano Ch., Coriat P. (2001). A Comparison of Sevoflurane, Target-Controlled Infusion Propofol, and Propofol/Isoflurane Anesthesia in Patients Undergoing Carotid Surgery: A Quality of Anesthesia and Recovery Profile, Anesthesia & Analgesia, 93(3):560-565.
  6. Absalom A & Struys M. An Overview of TCI & TIVA. Second Edition., 2011; Gent: Academia Press.