Abstract
In recent years, total intravenous anesthesia (TIVA) has been able to be easily and safely performed because of the release of remifentanil. However, there are some points which should be paid attention to during the practice of TIVA.
Individual differences for the need for propofol for adequate sedation level is greater than for inhalational anesthetics. Use of target controlled infusion (TCI) system and BIS monitoring is necessary for the safe practice of TIVA. The important points are controversial dissociation between blood and calculated propofol concentrations in 3 compartment models during induction of anesthesia and the effects of remifentanil on BIS during propofol infusion.
We need to understand the pharmacokinetics of propofol and the interpretation of electroencephalogram for safe practice of TIVA. These aspects are essential for sevoflurane anesthesia. TIVA should be performed as a learning tool in anesthesiology for all anesthesiologists.
