107 TIVA for GA caesarean with Parita & Sneha

Hi everyone,

This week three of us sit down to discuss a great review article (and topic) - the use of TIVA (total intravenous anaesthesia) for GA caesarean surgery.

For many the classic technique for a GA caesarean has been thio / sux tube then volatile & nitrous oxide. In recent years many aspects of this have started to change with propofol probably more commonly used as the i.v. induction agent and now in many cases rocuronium is used in preference to suxamethonium. Now with the much increased use of TIVA across anaesthesia practice there is a renewed interest in it's role for women having caesarean surgery and GA for management of postpartum haemorrhage.

Join us as we discuss this article. What do we mean by TIVA? What are the potential benefits? (uterine tone, recovery, PONV) and are there risks? (awareness, fetal depression, over sedation).

It is fair to say there has not been a lot of high quality research done on this topic and there are more questions than definitive answers, but this article does well to summarise the issues and what we do know.

Informal Twitter Poll result from Parita!:

References

The role of total intravenous anaesthesia for caesarean delivery. Y. Metodiev, D.N. Lucas IJOA April 08, 2022

Comments on above article - M.Paech IJOA June 28, 2022