Overview of total intravenous anesthesia in children.

Total intravenous anesthesia (TIVA) can be defined as a technique, in which general anesthesia is induced and maintained using purely i.v. agents. TIVA has become more popular and possible in recent times because of the pharmacokinetic (PK) and pharmacodynamic properties of propofol and the availability of short-acting synthetic opioids. Also, new concepts in PK modeling and advances in computer technology have allowed the development of sophisticated delivery systems, which make control of anesthesia given by the i.v. route as straightforward and user friendly as conventional, inhalational techniques. Monitoring of depth of anesthesia is being validated for these techniques, and in the future, measurements of expired propofol may be possible to guide administration. TIVA is being used increasingly in children.