ObsTIVA-UK: Obstetric Total Intravenous Anaesthesia in the UK

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.

Participation involved:

• 30 maternity units across the UK

• Data collection for 104 caesarean deliveries performed under TIVA between November 2022 and June 2023

Key findings included:

• A high incidence of videolaryngoscopy (92%) and the use of rocuronium as the primary neuromuscular blocker (78%)

• Significant variation in induction techniques based on urgency

• Neonatal outcomes demonstrated higher than expected rates of respiratory intervention post-delivery under TIVA

This study provides the largest dataset on obstetric TIVA to date, underscoring the need for further research to optimise techniques and outcomes in this area.

Quantitative and qualitative data from this project have been published in Anaesthesia Reports (May 2024) - doi:10.1002/anr3.12293