Titrated total intravenous anaesthesia (TIVA) in war

In the Rama mobile war hospital, intravenous (i.v.) anaesthesia was used in 78 patients undergoing surgical procedures lasting 4-25 min. Boluses of thiopentone (Group 1), propofol (Group 2), propofol + alfentanyl (Group 3), and ketamine + midazolam (Group 4) were used. Induction of anaesthesia, resulted in a mean blood pressure decreased about 15%. Apnoea of more than 20 sec was observed in Group 3, but no naloxone was required. Recovery was rapid enabling patients to maintain their own airway. The use therefore of titrated anaesthetics in war is considered acceptable.