Total intravenous anaesthesia

摘要

Total intravenous anaesthesia (TIVA) is a technique to induce and maintain general anaesthesia exclusively with intravenous anaesthetic agents, thereby avoiding the use of inhalational agents. It is essential that all practicing anaesthetists are competent in the delivery of TIVA and able to perform it safely. TIVA is necessitated in a wide variety of clinical situations when the delivery of inhalational agents is absolutely or relatively contraindicated; for example, in patients with malignant hyperthermia or severe postoperative nausea and vomiting. In other situations, it may not be possible or practical to deliver inhalational anaesthesia such as during patient transfer or anaesthesia for airway surgery. This article describes the use of target controlled infusion models and principles, which enable anaesthetists to deliver TIVA safely. The Association of Anaesthetists of Great Britain and Ireland and the Society of Intravenous Anaesthesia have produced Guidelines for safe practice of TIVA in 2018.