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)[1] on accidental awareness during general anaesthesia, found that patient self-reported cases of awareness appeared to be more common when TIVA was used. Mos