Chapter 14
Total Intravenous Anesthesia (TIVA)

Who needs gas?

Martin J. Kennedy

Anesthesiologist, MedVet Animal Medical and Cancer Center for Pets, Ohio, USA

1. Q. What is total intravenous anesthesia?
   
2. A. Total intravenous anesthesia (TIVA) is the use of one or more injectable anesthetic drugs for the maintenance of general anesthesia instead of using a volatile inhalant (e.g., isoflurane or sevoflurane) for maintenance.
   
3. Q. What are the advantages of TIVA compared to inhalant anesthesia?
   
4. A. Potential advantages of TIVA include:
   
   
   
   • better hemodynamics;
     
   • smoother recoveries;
     
   • better intra-operative analgesia;
     
   • no potential for personnel or environmental (i.e., ozone depletion) exposure to volatile anesthetics;
     
   • less specialized equipment is required (i.e., agent specific vaporizer, oxygen source, anesthesia machine, breathing circuit, scavenge, etc.).
   
   
5. Q. What are the potential disadvantages of TIVA?
   
6. A. Potential disadvantages of TIVA include:
   
   
   
   • the need for programmable syringe pumps;
     
   • respiratory depression and hypoxemia without supplemental oxygen;
     
   • drug accumulation and delayed recoveries with prolonged infusions.
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