Abstract
I investigated the current conditions surrounding the clinical use of propofol for TIVA/TCI. The survey revealed that TIVA was performed in more than 50% of patients undergoing open-thoracic or cardiac surgery, although this incidence differed depending on the operative procedure. Factors often indicated by anesthesiologists as reasons for hesitating to perform TIVA were: (1) adjustment is easier with volatile anesthesia ; and (2) the anesthesiologist is more familiar with volatile anesthesia. Experience with cases of delayed awakening from anesthesia was another reason for hesitating to choose TIVA.
According to the tutorial guidelines for anesthesiology residents of the Japanese Society of Anesthesiologists, the goal of using TIVA with propofol is acquiring the skills to perform total intravenous anesthesia with propofol. Training in propofol TIVA/TCI thus appears to be necessary for anesthesiology residents. This paper presents the current status of TIVA/TCI tutorials at our facility and discusses the anticipated effects of this type of tutorial.
