Total intravenous anesthesia for the pediatric patient: a narrative review
Anesthesia, Intravenous, Pediatric Anesthesia, Review
Published online: Feb 11 2025
Abstract
Objective: To undertake a database and registry search of scientific literature of the past ten years (2014-2024) and review findings in the format of a narrative review.
Methods: A literature search was carried out using the following databases and registries: NIHM Pubmed, The Cochrane Library, Wiley Online Library. Searches were performed using the following search terms in title and abstract: (anesthesia, intravenous) AND (anesthesia, pediatric) AND ((total intravenous anesthesia) OR (target controlled infusion)). Results were then filtered to show records published between the years 2014 and 2024. Inclusion criteria were: research on TIVA or comparing TIVA to IHA; a pediatric study population; systematic review, meta-analysis or randomized controlled trial. 34 studies of the last ten years pertaining to TIVA practice in pediatric anesthesiology were retained. Based on these articles a narrative review was conducted.
Summary: Total Intravenous Anesthesia (TIVA) has been proven safe and its use by anesthesiologists in the pediatric population is rising. In this review, established evidence, known advantages and disadvantages of TIVA in the pediatric population are first summarized. Recent findings in different topics pertaining to TIVA are then explored: facilitating intravenous induction in the pediatric patient by (non)pharmacological means; anesthetic drug development, its hurdles in pediatric practice; pharmacokinetic/pharmacodynamic modeling; developmental neurology; electroencephalographic guided anesthesia practice; emergence delirium; TIVA use in different clinical contexts; environmental and economic impact of TIVA; immune response to surgery and anesthesia and finally a short foray into genetics brings us to a tie-in of this broad subject, along with some concrete avenues for future research.
The manuscript aims to give an overview of up-to-date information in order to provide inspiration and a springboard for research into the coming years.
