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Obs-TIVA UK
Obs-TIVA UK
Prevalence and current practice of obstetric total intravenous anaesthesia in the United Kingdom (Obs-TIVA UK): a service evaluation
Prevalence and current practice of obstetric total intravenous anaesthesia in the United Kingdom (Obs-TIVA UK): a service evaluation
Cardiff and Vale University Health Board
Cardiff and Vale University Health Board
Project lead: Dr Yavor Metodiev
ObsTIVA-UK was a prospective, multicentre service evaluation led by the University Hospital of Wales. While total intravenous anaesthesia (TIVA) is increasingly utilised across UK anaesthetic practice, its application within obstetric general anaesthesia has not been systematically evaluated. This project aimed to describe the incidence and practice of TIVA for obstetric surgery and to evaluate associated maternal and neonatal outcomes.
Obstetric general anaesthesia is critical in emergencies, yet the role of TIVA in improving maternal and neonatal outcomes remains unclear. This evaluation provided valuable insights into current practice, highlighting changes in airway management and the use of anaesthetic agents within this population.
Primary outcomes
To establish the current incidence of total intravenous anaesthesia (TIVA) for obstetric surgical interventions in the UK.
Secondary outcomes
Describe current practices when performing TIVA for obstetric surgery
Describe medical and obstetric characteristics of patients who receive TIVA
Describe the use of pEEG monitoring in obstetric TIVA
Describe adverse events when TIVA is used for obstetric surgery
To evaluate the effect of TIVA on the incidence and severity of postpartum haemorrhage
Describe the postoperative recovery period in patients who received TIVA for obstetric surgery
Describe effects of TIVA on the neonate
You can find more information here.
Summary of results
Summary of results
ObsTIVA-UK included 104 caesarean deliveries under TIVA from 30 UK maternity units between November 2022 and June 2023.
TIVA accounted for 6.6% of obstetric general anaesthetics, but only 0.3% of all caesarean deliveries in participating units.
Most TIVA caesarean deliveries were non-emergency cases, with category 4 caesarean delivery the largest group.
The most commonly documented reason for using TIVA was the anaesthetist's preference.
Propofol target-controlled infusion was used in almost all caesarean delivery cases.
Processed EEG monitoring was used in most cases, but there was variation in induction technique, particularly around propofol bolus and remifentanil use.
Neonatal respiratory intervention was more common than expected from existing obstetric general anaesthesia data
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