The first nationally agreed guidelines on the safe practice of total intravenous anaesthesia (TIVA) have been produced by The Association of Anaesthetists and the Society for Intravenous Anaesthesia. TIVA is the maintenance of general anaesthesia by an intravenous drug infusion rather than by more conventional, inhaled, anaesthetic drugs.
Training and competency are key to delivering TIVA safely. Dr Alastair Nimmo (Consultant Anaesthetist, Royal Infirmary of Edinburgh) and one of the guideline authors explains: “TIVA has advantages for some patients and in certain situations is the only technique that can be used. However, recent surveys of anaesthetists working in the UK and Ireland have suggested that training in TIVA is currently inconsistent and often inadequate.
“In 2014, the 5th National Audit Project (NAP5) on accidental awareness during general anaesthesia, found that patient self-reported cases of awareness appeared to be more common when TIVA was used. Most of the cases were considered preventable and that the most common contributory factor was inadequate operator education and training. These new guidelines support anaesthetists to deliver safe TIVA by recommending education and training”.
The guidelines include a set of 10 key recommendations that cover best practice for administration and monitoring of TIVA. In addition, the guidelines specify four key areas of knowledge required by an anaesthetist using TIVA.
Other news from BJC Issue 1, 2019:
British Geriatrics Society Cardiovascular Section partners with the BJC
London begins NHS video consultations in cardiology
New anticoagulant drug class in development
Cytokine removal in sepsis and endocarditis
News in brief