Guidelines for the safe practice of total intravenous anaesthesia (TIVA)
Summary
Guidelines are presented for safe practice in the use of intravenous drug infusions for
general anaesthesia. When maintenance of general anaesthesia is by intravenous infusion,
this is referred to as total intravenous anaesthesia. Although total intravenous anaesthesia
has advantages for some patients, the commonest technique used for maintenance
of anaesthesia in the UK and Ireland remains the administration of an inhaled volatile
anaesthetic. However, the use of an inhalational technique is sometimes not possible, and
in some situations, inhalational anaesthesia is contraindicated. Therefore, all anaesthetists
should be able to deliver total intravenous anaesthesia competently and safely. For the
purposes of simplicity, these guidelines will use the term total intravenous anaesthesia
but also encompass techniques involving a combination of intravenous infusion and
inhalational anaesthesia. This document is intended as a guideline for safe practice when
total intravenous anaesthesia is being used, and not as a review of the pros and cons
of total intravenous anaesthesia vs. inhalational anaesthesia in situations where both
techniques are possible.
doi:10.1111/anae.14428
