Course: Introduction to Using Total Intravenous Anaesthesia (TIVA)

Anaesthesia has traditionally been administered by the inhalational route and this practice has persisted despite the development of better intravenous drugs and the technology to infuse them accurately and safely. …

Life Cycle Analysis (LCA) Evaluates the environmental impact of a product over its entire life cycle. Holistic approach that takes into account all the activities involved in the creation of …

Week 7 Global Warming This week we outline the problem that is the carbon footprint of healthcare. How our daily decision of what anaesthetic we use impacts global warming. We …

An Introduction to Total Intravenous Anaesthesia Congratulations on completing the course The information you have learnt over the last 7 weeks has now armed you with the tools to deliver …

Propofol PD effects of propofol usually ensure a smooth, clear-headed awakening PK characteristics and TCI infusion models allow reasonable recovery times from anaesthesia Emergence agitation and delirium is less compared …

Procedural Sedation No generally accepted definition The practice of procedural sedation is the administration of one or more pharmacological agents to facilitate a diagnostic or therapeutic procedure while targeting a …

Resistance to change Change around us is continuous and in modern medicine the pace of advancement is rapid It is human nature to reject change To embrace change, it is …

Blood vs. Effect-site control The effect-site concentration lags behind the plasma concentration because of the blood-brain barrier TCI systems can reduce this delay by raising the plasma concentration beyond the …

Total intravenous anaesthesia with propofol Propofol is a fast onset, short-acting intravenous anaesthetic Favourable pharmacokinetic properties allow accurate titration Suitable for both induction and maintenance of anaesthesia Propofol has a …

Point to note: “Guidelines for the safe practice of TIVA” – Joint Guidelines from the Association of Anaesthetists and the Society for Intravenous Anaesthesia In the section relating to obstetrics …

Establishing the Baseline The HKU department of anaesthesia carried out an international survey to gauge the factors that have hampered widespread uptake Respondents were divided into groups depending on their …

Marsh Model One of the first developed (Gavin Kenny and colleagues). A relatively simple but good model that has been used in clinical practice for > 30 years Familiar with …

Limitations of Any Models Most pharmacokinetic models were developed in a small group of young, healthy, non-obese subjects Large inter-individual and intra-individual differences exist Plasma drug concentrations in any individual …

Week 6 Special Patient Cohorts TIVA is a technique that can be used for all types of patients. Before we use TIVA for any patient we need to question whether …

Week 6 Smooth Recovery and Sedation To ensure a “smooth” recovery many component parts need to be considered. This week we talk through the various factors affecting recovery. Some useful …