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The Advantages of TIVA
Published online by Cambridge University Press: 18 November 2019
Like many of you, we’re sure, we were trained to use IV anaesthetic agents for induction of anaesthesia but volatiles for maintenance – a sensible and seemingly safe combination that has been used for decades. So why change? The initial attraction of TIVA was the extremely rapid, smooth and clear-headed recovery of patients when using propofol as the hypnotic component of an anaesthetic. This is particularly apparent when the drug is used for cases of short to intermittent duration, for example in day-case surgery with earlier discharge from the post-anaesthetic care unit.[1] Clearly in modern practice, which is moving towards shorter in-patient stays, this represents a major advantage. In addition, improved levels of patient satisfaction occur with TIVA, presumably due to the favourable recovery profile.[2] Certainly, desflurane and sevoflurane allow rapid recovery but it is not as smooth, there may be more emergence delirium and quality indicators are not as good.[3]
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