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

Abstract

IntroductionThe use of total intravenous anaesthesia (TIVA) has been growing worldwide over the past 20 years due to the creation of new drugs and the development of new target-controlled infusion pumps, many of which have already been approved in the United States by the FDA (Food and Drugs Administration), in Europe and in Colombia. However, the use of TIVA has not been expanded yet as part of routine practice. ObjectiveTo determine the frequency of TIVA use in our country and to identify existing barriers for its implementation. Materials and methodsSurvey designed to determine the use of TIVA in general anaesthesia practice in Colombia. A representative random sample of the universe of anaesthetists registered in the database of the Colombian Society of Anaesthesiology and Resuscitation (S.C.A.R.E.) was calculated. Reminders were sent by e-mail and some of the selected respondents were contacted by phone. ResultsOverall, 141 (32.4%) responses were obtained. The frequency of TIVA use was reported as Always, 7 (5.0%), Almost Always, 52 (36.9%), Hardly Ever, 57 (40.4%) and Never, 25 (17.7%). The techology used for TIVA administration included macro drip devices (n=30, 21.3%), volumetric pumps (n=76, 53.9%), TCI pumps (n=45, 31.9%), and computer programmes (n=9, 6.4%). The limitations identified for the use of TIVA included low availability of anaesthesia depth monitoring (n=68, 48.2%) and infusion pumps (n=52, 36.9%), lack of experience (n=41, 29.1%), little availability of workshops (n=26, 18.4%), low availability of medications (n=23, 16.3%), fear of intra-operative recall (n=22, 15.6%), limited knowledge of pharmacology (n=18, 12.8%), increased anaesthesia time (n=13, 9.2%), and perceived difficulty for performing the technique (n=13, 9.2%). ConclusionsThe use of TIVA has been limited by the low availability of technology, lack of experience or knowledge among anaesthetists, and a preference for the balanced anaesthesia technique. Many anaesthesiologists prefer balanced techniques for general anaesthesia. Some devices used for TIVA administration raise concerns about patient safety.