Over the course of the last decade, the role of TIVA in pediatrics has increased. Traditionally, most anesthesiologists have preferred the inhalation technique because it is easy to administer and allows a gentle induction with a recovery in the established times. However, in recent years, TIVA has demonstrated clinical advantages compared to inhalation, including low incidence of nausea, and vomiting in the postoperative period, and precise control of drug delivery, reduced risk of airway irritation, and smooth emergence from anesthesia.
TIVA can be an interesting alternative in pediatrics and its use is becoming more popular due to the pharmacokinetic and pharmacodynamic properties of propofol and the availability of short-acting synthetic opioids. TIVA has been seen to be beneficial in those with preoperative respiratory symptoms by reducing the frequency of complications, minimizing the stress and discomfort associated with the phases of anesthesia. This is especially beneficial in pediatric patients who may be anxious or have difficulty cooperating with inhaled induction techniques.
Anesthesiology researchers are finding new and better ways to treat pediatric patients, and exploring new and safer drugs that continue to decrease the risk of long-term outcomes in children. TIVA in pediatrics should be performed by experienced anesthesiologists who are well-versed in pediatric anesthesia principles and dosing requirements. They closely monitor the child’s vital signs, depth of anesthesia, and adjust drug dosages accordingly to ensure safety and optimal surgical conditions.
Advantages of TIVA in Children
- Less postoperative nausea and vomiting
- Less operating room pollution
- Reduce airway reactivity, laryngospasm, and bronchospasm
- Advocated for neuromuscular disease, core myopathies, and muscular dystrophy
- Less interference with evoked potential monitoring
- Associated with overall reduced costs
- Reliable delivery in airway procedure
- Smooth recovery
- Suitable for Patients with respiratory issues
Disadvantages of TIVA in Children
- Need for venous access, pain on injection
- No current ability to monitor blood concentration
- Delivery problems may go unrecognized
- Need specialized equipment
- Less training available for TIVA techniques
- Drugs require metabolism for clearance
- Risk of associated metabolic phenomena
- Potential for disconnection, risk of awareness
- Depth of anesthesia monitors in young children are unreliable
Health Line TIVA Sets
Here at Health Line, we offer TIVA sets to simplify practices, reduces drug waste, and promotes accurate delivery of drugs introduced closer to the patient’s IV access in a safe and controlled manner. Learn more here.
For more information about our TIVA sets, please contact your Health Line Sales Consultant at (877) 847-4542 or firstname.lastname@example.org
Vaithianadan Mani, Nel S Morton. (2009, August 10). Overview of total intravenous anesthesia in children. National Library of Medicine. Overview of total intravenous anesthesia in children – PubMed (nih.gov)
J Gaynor, BM FRCA, J M Ansermino. (2016, May 10). Paediatric total intravenous anaesthesia. Oxford Academic. https://www.bjaed.org/article/S2058-5349(17)30022-7/fulltext
Anderson, B. Bagshaw, O. (July 2019). Practicalities of Total Intravenous Anesthesia and Target-controlled Infusion in Children, ASA Publications. https://pubs.asahq.org/anesthesiology/article/131/1/164/18098/Practicalities-of-Total-Intravenous-Anesthesia-and
Grace Lai Sze Wong. (2011, September 14). Total Intravenous Anesthesia (TIVA) in pediatric cardiac anesthesia. HAL Open Science. https://hal.science/hal-00623320v1/file/PEER_stage2_10.1111%252Fj.1460-9592.2011.03565.x.pdf
Health Line International Corp. is not responsible for any errors, omissions, injury, loss, or damage arising from or relating to the use (or misuse) of any information, statements, or conclusions contained in or implied by the contents of this document or any of the source materials. This content is not intended to replace professional medical advice.