Curriculum Resources


Stage 1 and 2 Neuroanaesthesia

TIVA for Neuroanaesthesia

Published on 17 March, 2022

Last modified on April 1st, 2022

Curriculum Reference

15.9.1 Analyses the risks and benefits of available anaesthetic techniques for differing neuroscience procedures including TIVA, processed EEG, neurophysiological monitoring, awake testing, and the implications of patient positioning.

12.9.1 Safely manages induction and maintenance of anaesthesia by inhalational and intravenous techniques, extubation and emergence from anaesthesia.

12.9.1.1 Describes the principles of total intravenous anaesthesia and uses it safely in clinical practice for non-complex cases.

13.9.1.9 Uses total intravenous anaesthesia safely in all areas of clinical anaesthetic practice.

HiLLO7: Specialists in Intensive Care Medicine can provide pre-operative resuscitation and optimisation of patients, deliver post-operative clinical care including optimising their physiological status, provide advanced organ system support and manage their pain relief.

HiLLO 10: Intensive Care Medicine specialists will have developed the necessary skills of induction of anaesthesia, airway control, care of the unconscious patient and understanding of surgery and its physiological impact on the patient.

Relevant Review Articles

Principles of total intravenous anaesthesia: practical aspects of using total intravenous anaesthesia BJA Education BJA Education, 16(8), 2016, 276–280, 

Principles of total intravenous anaesthesia: basic pharmacokinetics and model descriptions BJA Education, 16 (3), 2016, 92–97

Pharmacokinetic models for propofol—defining and illuminating the devil in the detail British Journal of Anaesthesia 103, 2009, 26-37

Absalom & Struys An Overview of TCI & TIVA 2020: ISBN: 9401462836

Further Reading (incl. Key Trials)

Propofol vs. inhalational agents to maintain general anaesthesia in ambulatory and in-patient surgery: a systematic review and meta-analysis: BMC Anesthesiology 2018; 18: 162.

Comparison of propofol and volatile agents for maintenance of anaesthesia during elective craniotomy procedures: systematic review and meta-analysis. Canadian Journal of Anaesthesia 61(4), 2014 :347-356

Intravenous versus inhalational maintenance of anaesthesia for postoperative cognitive outcomes in elderly people undergoing non‐cardiac surgery: Cochrane Database of Systematic Reviews 2018, Issue 8

The anaesthetist’s choice of inhalational vs. intravenous anaesthetics has no impact on survival of glioblastoma patients Neurosurgical Review 44, 2021, 2707-2715

National Guidance/Standards

Joint guidelines from the association of anaesthetists and the Society of Intravenous Anaesthesia: Guidelines for the safe practice of total intravenous anaesthesia (TIVA) Anaesthesia 2019, 74, 211–224

e-learning

e-Learning for anaesthesia: Module 02: Consolidating clinical practice: Maintenance of Anaesthesia: General Principles: Intravenous maintenance of anaesthesia

e-Learning for anaesthesia: Module 07c: Pharmacology: Pharmacokinetics: Pharmacokinetics of intravenous anaesthesia

e-Learning for anaesthesia: Module 04c: Paediatrics: Maintenance of Anaesthesia: TIVA principles in children

Online Resources

5th national audit project (NAP5): TIVA

The Society of Intravenous Anaesthesia

TIVA Podcast (BJA Education):

RCoA Audit Compendium

Chapter 2 Section 7: TIVA/TCI training for anaesthesia and intensive care trainees

NACCS Webinars & Video

10/5/2018 10.25 TIVA and Neuro; NAP5, Guidelines Guessing and Gremlins
3/9/2016 15.15 Cognitive dysfunction following anaesthesia
18/3/2017 10.00 Improving outcome; lessons from our colleagues – TIVA and cancer 

Upcoming events

NACCS ASM May 9-10 Birmingham, Neuro-anaesthesia update, including TIVA

https://whova.com/embedded/session/PNpy+n+0R1uFaYxRcA0L208W1G1OT4u0nlGcVXsZr5w=/2121881/?widget=primary

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