TIVA & target-controlled infusion (TCI)

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Target exams

Red flags

• An ongoing concern with TIVA is the increased incidence of unintended awareness; unlike volatile delivery, there is no end-tidal monitoring to confirm propofol delivery.
• Interruptions of anaesthetic delivery during movement from anaesthetic room to theatre contributed to accidental awareness at induction in NAP5.
• Syringes should be clearly labelled with content and drug concentration.
• Predicted propofol concentrations at loss of consciousness vary considerably across PK/PD models, so the model must be stated explicitly.
• Propofol infusion syndrome is associated with infusions above 4 mg/kg/h for more than 48 hours.