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Error Traps in Pediatric Total Intravenous Anesthesia Knowledge Gaps and a Practical Perspective

Lucas Guimarães Ferreira Fonseca1,2, Adam Keys3,4, Matthew Hart5

  • 1Department of Anaesthesia, The Royal Children's Hospital, Melbourne, Victoria, Australia.

Paediatric Anaesthesia
|September 16, 2025
PubMed

Insights

Pediatric total intravenous anesthesia (TIVA) using propofol is safe and effective, yet underutilized. This article addresses barriers and provides principles for its successful implementation in children.

Area of Science:

  • Anesthesiology
  • Pediatric Medicine
  • Pharmacology

Background:

  • Propofol-based pediatric total intravenous anesthesia (TIVA) is a safe alternative to volatile anesthesia.
  • Despite benefits, TIVA use in pediatrics is limited due to training gaps and perceived complexity.

Purpose of the Study:

  • To explore key principles for the safe and effective administration of pediatric TIVA.
  • To address barriers hindering the wider adoption of TIVA in pediatric anesthesia.

Main Methods:

  • Review of pharmacological principles relevant to pediatric TIVA.
  • Discussion of adjunct agents, drug delivery systems, and electroencephalography monitoring.
  • Consideration of TIVA application in specific pediatric populations.

Main Results:

  • Identified key principles for safe and effective pediatric TIVA.
  • Highlighted strategies to overcome common barriers to TIVA implementation.
  • Provided guidance on monitoring and use in diverse pediatric groups.

Conclusions:

  • Optimizing pediatric TIVA requires addressing knowledge gaps and enhancing confidence.
  • Effective implementation involves understanding pharmacology, monitoring, and patient-specific factors.
  • Increased awareness of TIVA benefits can improve its utilization in pediatric anesthesia.

Keywords:
TIVAanesthesiachildrenintravenouspharmacologypropofol

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