Use of total intravenous anaesthesia in Colombia: A national survey among active anaesthetists in Colombia☆

Echeverry-Marín, Piedad Cecilia; Arevalo, Jimmy J.; Pinzón, Paola Vernaza; Vanegas-Saavedra, Alberto; Leguizamón, Miryam

doi:10.1097/01819236-201704000-00008

Cited by 1 publication

(1 citation statement)

References 17 publications

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“…Mini-Spike® 2, 50-100 ml propofol vials, minimum volume infusion lines) and promotion of increasingly prevalent masterclass style seminars on efficient and safe TIVA delivery. In contrast to the findings of other international surveys 19,20 , ANZCA Fellows appear to have reliable access to both pumps and depth of anaesthesia monitoring and are comfortable with pump setup. There was a clear preference for administering TIVA using plasma or effect site target-controlled modelling (only ten percent of respondents use fixed infusion strategies) and programmable (pharmacokinetic) pumps are available in more than 80 percent of cases.…”

Section: Discussioncontrasting

confidence: 79%

Inhalational versus Propofol-Based Total Intravenous Anaesthesia: Practice Patterns and Perspectives among Australasian Anaesthetists

Lim

Braat

Hiller

et al. 2018

Anaesth Intensive Care

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Increasing evidence suggests that total intravenous anaesthesia (TIVA) may be the preferred anaesthetic for cancer resection surgery. To assist the preparation of a randomised controlled trial (RCT) examining Volatile (versus TIVA) Anaesthesia and Perioperative Outcomes Related to Cancer (VAPOR-C) we developed an 18-question electronic survey to investigate practice patterns and perspectives (emphasising indications, barriers, and impact on cancer outcomes) of TIVA versus inhalational general anaesthesia in Australasia. The survey was emailed to 1,000 (of 5,300 active Fellows) randomly selected Australian and New Zealand College of Anaesthetists (ANZCA) Fellows. The response rate was 27.5% (n=275). Of the respondents, 18% use TIVA for the majority of cases. In contrast, 46% use TIVA 20% of the time or less. Respondents described indications for TIVA as high risk of nausea, neurosurgery, and susceptibility to malignant hyperthermia. Lack of equipment, lack of education and cost were not considered barriers to TIVA use, and a significant proportion (41%) of respondents would use TIVA more often if setup were easier. Of the respondents, 43% thought that TIVA was associated with less cancer recurrence than inhalational anaesthesia, while 46% thought that there was no difference. Yet, only 29% of respondents reported that they use TIVA often or very often for cancer surgery. In Australasia, there is generally a low frequency of TIVA use despite a perception of benefit when compared with inhalational anaesthesia. Anaesthetists are willing to use TIVA for indications where sufficient evidence supports a meaningful level of improvement in clinical outcome. The survey explores attitudes towards use of TIVA for cancer surgery and demonstrates equipoise in anaesthetists' opinions regarding this indication. The inconsistent use of TIVA in Australasia, minimal barriers to its use, and the equipoise in anaesthetists' opinions regarding the effect of TIVA versus inhalational anaesthesia on cancer outcomes support the need for a large prospective RCT.

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Section: Discussioncontrasting

confidence: 79%