Question

Enumerate the indications, advantages, and disadvantages of TIVA.

Hint:

Always ensure continuous monitoring of intravenous drug concentrations during TIVA to avoid complications like overdose or prolonged anaesthesia.

Answer 1

Step 1: Understanding the Indications of TIVA.
Total Intravenous Anaesthesia (TIVA) is indicated for a variety of reasons:
- Patients with inhalation agent intolerance: Some patients are allergic or have adverse reactions to inhaled anaesthetic agents, making TIVA a safer alternative.
- Controlled anaesthesia profile: TIVA is ideal for situations where precise control over anaesthetic depth is required, as it allows for better titration of the anaesthetics.
- Contraindications for inhalation anaesthesia: For example, patients with certain respiratory conditions may not tolerate inhaled agents, and TIVA provides an alternative.

Step 2: Advantages of TIVA.
The advantages of TIVA include:
- Reduced environmental pollution: Since TIVA eliminates the need for volatile agents, it is more environmentally friendly.
- Avoidance of inhaled agents: TIVA allows for complete intravenous administration, which is beneficial for patients who may have adverse reactions to volatile anaesthetics.
- Fewer side effects: For some patients, TIVA may result in fewer side effects, such as nausea and vomiting, compared to traditional anaesthesia.

Step 3: Disadvantages of TIVA.
The disadvantages of TIVA include:
- Need for continuous monitoring: Since TIVA uses intravenous agents, it is crucial to monitor the drug levels closely to avoid complications such as overdose or underdose.
- Drug accumulation: Certain drugs used in TIVA may accumulate in the body, leading to prolonged effects after surgery, especially in patients with poor liver or kidney function.
- Technical complexity: The use of TIVA requires precise calculations and monitoring, which can be more technically challenging compared to inhalation anaesthesia.

Step 4: Conclusion.
TIVA is a valuable anaesthesia technique with many advantages, such as reducing environmental pollution and offering a controlled anaesthesia profile. However, it also has some drawbacks, including the need for continuous monitoring and the potential for drug accumulation. Understanding when to use TIVA and the associated risks is essential for safe anaesthesia practice.