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Total intravenous anesthesia versus inhalation anesthesia: how do outcomes compare?
1Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Current Opinion in Anaesthesiology
|June 20, 2023
Summary
Propofol-based total intravenous anesthesia (TIVA) offers benefits for specific surgical scenarios, particularly in reducing postoperative nausea and vomiting. However, its use is limited by perceived risks and a lack of evidence in some clinical situations.
Area of Science:
- Anesthesiology
- Surgical Care
Background:
- General anesthesia employs volatile anesthetics or propofol-based total intravenous anesthesia (TIVA).
- Despite proven safety, propofol-based TIVA utilization is low.
- Perceived risks, device limitations, and clinician preference contribute to low TIVA use.
Approach:
- This review synthesizes clinical evidence comparing propofol-based TIVA and volatile anesthetics.
- Outcomes examined include postoperative nausea and vomiting, pain, recovery quality, cognitive dysfunction, and cancer outcomes.
Key Points:
- Propofol-based TIVA may benefit patients experiencing postoperative nausea and vomiting.
- Evidence supporting propofol-based TIVA in certain clinical scenarios remains limited.
- The strength of evidence for propofol-based TIVA varies across different postoperative outcomes.
Conclusions:
- Propofol-based TIVA presents advantages in specific postoperative scenarios.
- Clinical application of propofol-based TIVA is debated due to inconsistent evidence.
- Further research is needed to clarify the role of propofol-based TIVA in diverse surgical contexts.
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