Related Experiment Video
Updated: May 11, 2026
06:40
An In Vivo Mouse Model of Total Intravenous Anesthesia During Cancer Resection Surgery
Published on: June 8, 2021
Total intravenous anesthesia for major burn surgery
Leopoldo C Cancio1, Phillip B Cuenca, Stephen C Walker
1U.S. Army Institute of Surgical Research Fort Sam Houston, Texas, USA.
International Journal of Burns and Trauma
|May 3, 2013
Summary
Total intravenous anesthesia (TIVA) is a safe and effective anesthetic option for critically ill burn patients undergoing major surgery. This approach, utilizing various intravenous drugs, did not increase hemodynamic instability in sicker patients.
Area of Science:
- Anesthesiology
- Burn Surgery
- Critical Care Medicine
Background:
- Total intravenous anesthesia (TIVA) is frequently employed for major operations in critically ill burn patients.
- This study reviews the clinical experience with TIVA in this specific patient population.
Purpose of the Study:
- To evaluate the safety and efficacy of TIVA in critically ill burn patients.
- To compare patient characteristics and outcomes between TIVA and non-TIVA general anesthesia.
Main Methods:
- A retrospective review of 112 TIVA cases and 75 randomly selected non-TIVA cases from 547 major burn surgeries over 22 months.
- Patients were categorized based on exposure to TIVA for inter-patient analysis.
- Data on patient demographics, injury severity, and anesthetic management were collected.
Main Results:
- Excision and grafting were the most common procedures (78.2%).
- TIVA was administered using ketamine, methadone, fentanyl, and propofol, often in higher doses than in non-burn patients.
- TIVA patients had higher ASA scores, greater burn size (TBSA), and higher rates of inhalation injury compared to non-TIVA patients.
- Intraoperative pressor use was similar between TIVA and non-TIVA groups.
Conclusions:
- TIVA is utilized in burn patients with more severe injuries, including higher inhalation injury rates and TBSA.
- TIVA in critically ill burn patients is not associated with increased hemodynamic instability.
- TIVA represents a viable anesthetic approach for complex burn surgeries.
Related Concept Videos
01:16Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
One of the advantages of...
01:24Parenteral Anesthetics: Overview
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
01:24General Anesthesia: Overview
Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
01:22Burn Injuries
Burn injuries occur when the skin and underlying tissues are damaged due to exposure to heat, electricity, chemicals, radiation, or friction. They can vary in severity, from minor superficial burns to severe deep burns that can be life-threatening.
The damage results in the death of skin cells, which can lead to a massive loss of fluid. Dehydration, electrolyte imbalance, and renal and circulatory failure follow, which can be fatal. Burn patients are treated with intravenous fluids to offset...
The damage results in the death of skin cells, which can lead to a massive loss of fluid. Dehydration, electrolyte imbalance, and renal and circulatory failure follow, which can be fatal. Burn patients are treated with intravenous fluids to offset...
01:11Local Anesthetics: Clinical Application as Spinal Anesthesia
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
01:22Stages of General Anesthesia
Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...