Report and Findings of the 5th National Audit Project Total Intravenous Anaesthesia

headline 18.1. There were 28 Certain/probable or Possible reports of AAGA involving intravenous anaesthesia. In 21 of them total intravenous anaesthesia (TIVA) was used for induction and maintenance of anaesthesia, and in seven the patient received both a volatile anaesthetic and an IV infusion of propofol. Twenty four cases occurred in theatre and an important cause was failure to deliver the intended dose of propofol. One quarter of cases occurred when anaesthesia was initiated or continued outside the operating theatre (where volatile anaesthesia would have been impossible). In these cases the commonest cause of AAGA was the administration to a paralysed patient of an inappropriately low dose infusion, usually as a fixed-rate infusion. More than three-quarters of the 28 cases of AAGA were considered to have been ‘preventable’. All anaesthetists need to be skilled in the administration of intravenous anaesthesia, and these results suggest that is not currently the case. Total intravenous anaesthesia CHAPTER 18