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Total intravenous anaesthesia techniques for ambulatory surgery
1Department of Anaesthesia, Oslo University Hospital, Ullevaal, Oslo, Norway.
Current Opinion in Anaesthesiology
|August 15, 2009
Summary
Total intravenous anaesthesia (TIVA) is a well-tolerated, simple method for ambulatory surgery, offering rapid recovery and fewer side effects. Propofol and remifentanil are the leading TIVA agents, enhancing patient care.
Area of Science:
- Anesthesiology
- Pharmacology
Background:
- Ambulatory surgery is increasingly common.
- Anesthesia techniques must balance efficacy with patient recovery.
Purpose of the Study:
- To review current applications of total intravenous anaesthesia (TIVA) in ambulatory surgery.
- To contextualize recent findings within existing knowledge.
Main Methods:
- Review of recent studies on TIVA for ambulatory surgery.
- Synthesis of findings with established TIVA principles.
Main Results:
- TIVA is widely used in ambulatory settings due to its simplicity and declining costs.
- Propofol-remifentanil combinations are favored, offering rapid emergence and low postoperative nausea/vomiting (PONV).
- Cost-effectiveness varies based on patient and perioperative factors.
Conclusions:
- TIVA is well-tolerated and simple, with lower PONV rates than inhalational anesthesia.
- No residual paralysis occurs with TIVA, unlike some regional techniques.
- Propofol-remifentanil, delivered via pumps or target-controlled infusion, dominates TIVA practice.
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