Prevalence of Awareness in Total Intravenous Anesthesia: A Cross-Sectional Study

Awareness in Total Intravenous Anesthesia

Authors

  • Maria Tariq Department of Anesthesia, Hayatabad Medical Complex, Medical Teaching Institution, Peshawar, Pakistan
  • Bakhtawar Zaman Department of Anesthesia, Hayatabad Medical Complex, Medical Teaching Institution, Peshawar, Pakistan
  • Muhammad Arsalan Khan Department of Anesthesia, Institute of Health Sciences, Khyber Medical University, Peshawar, Pakistan
  • Sara Rabbani Department of Anesthesia, Hayatabad Medical Complex, Medical Teaching Institution, Peshawar, Pakistan
  • . Khalid Department of Anesthesia, Mardan Medical Complex, Medical Teaching Institute, Peshawar, Pakistan
  • Fayyaz Akhter Qureshi Department of Anesthesia and Pain Management, Hayatabad Medical Complex, Medical Teaching Institution, Peshawar, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v6i2.2772

Keywords:

Total Intravenous Anesthesia, Intraoperative Awareness, Metabolic Equivalent Score, Prevalence

Abstract

reaction to stimuli, and the establishment of a tranquil surgical environment. Objective: To determine the prevalence of total intravenous anesthesia (TIVA) among patients in a tertiary care hospital. Methods: The research was a descriptive cross-sectional study. Total intravenous anesthesia was performed on 217 male and female patients aged 18–60 year. The patient's history in the first two post-operative days revealed intraoperative consciousness. Data were gathered, from 17th June, to November 30th, 2022. Statistical analysis was performed using SPSS version 23.0. Results: The study found that the prevalence of awareness during total intravenous anesthesia (TIVA) was 15.7%, with a higher occurrence in patients with metabolic equivalent test scores ≤4 (45.4%, p < 0.001) and those with a previous history of awareness (80.0%, p < 0.001). Gender (16.4% in males vs. 14.1% in females, p = 0.654), age (15.2% in ≤45 vs. 16.0% in >45 years, p = 0.865), BMI (17.2% in ≤23.0 vs. 13.9% in >23.0 kg/m², p = 0.494), diabetes (13.3% in diabetics vs. 16.6% in non-diabetics, p = 0.558), alcoholism (25.0% in alcoholics vs. 15.1% in non-alcoholics, p = 0.360), and ejection fraction (20.0% in ≤40% vs. 14.7% in >40%, p = 0.403) did not show statistically significant associations with awareness prevalence. Conclusions: Metabolic equivalent scores and a prior history of awareness were significant predictors of intraoperative awareness during TIVA, highlighting the importance of tailored preoperative evaluations.

References

Wong GT, Choi SW, Tran DH, Kulkarni H, Irwin M. An international survey evaluating factors influencing the use of total intravenous anaesthesia. Anaesthesia and Intensive Care. 2018 May; 46(3): 332-8. doi: 10.1177/0310057X1804600312. DOI: https://doi.org/10.1177/0310057X1804600312

Jia L, Hou J, Zheng H, Sun L, Fan Y, Wang X et al. Study of the rational dose of propofol in elderly patients under bispectral index monitoring during total intravenous anesthesia: A PRISMA-compliant systematic review. Medicine. 2020 Jan; 99(5): e19043. doi: 10.1097/MD.0000000000019043. DOI: https://doi.org/10.1097/MD.0000000000019043

Zoroufchi BH and Abdollahpour A. A Review on Novel Progressions in Intravenous (IV) agents for Anesthesia. Journal of Pharmaceutical Research International. 2019 Oct; 30(2): 1-3. doi: 10.9734/jpri/2019/v30i230266. DOI: https://doi.org/10.9734/jpri/2019/v30i230266

Parate LH, Kaur N, Iyer SS, Geetha CR. The study of postoperative recall in patients under total intravenous anesthesia. Anesthesia Essays and Researches. 2021 Apr; 15(2): 233-8. doi: 10.4103/aer.aer_126_21. DOI: https://doi.org/10.4103/aer.aer_126_21

Bullard TL, Cobb K, Flynn DN. Intraoperative and anesthesia awareness. 2022.

Navarro KL, Huss M, Smith JC, Sharp P, Marx JO, Pacharinsak C. Mouse anesthesia: the art and science. International League of Associations for Rheumatology Journal. 2021 Dec; 62(1-2): 238-73. doi: 10.1093/ilar/ilab016. DOI: https://doi.org/10.1093/ilar/ilab016

Lederman D, Easwar J, Feldman J, Shapiro V. Anesthetic considerations for lung resection: preoperative assessment, intraoperative challenges and postoperative analgesia. Annals of Translational Medicine. 2019 Aug; 7(15): 356. doi: 10.21037/atm.2019.03.67. DOI: https://doi.org/10.21037/atm.2019.03.67

Basha I. A systematic analysis on opioid-free general anesthesia versus opioid-based general anesthesia for bariatric surgery.

Ruhaiyem ME, Alshehri AA, Saade M, Shoabi TA, Zahoor H, Tawfeeq NA. Fear of going under general anesthesia: A cross-sectional study. Saudi journal of anaesthesia. 2016 Jul; 10(3): 317-21. doi: 10.4103/1658-354X.179094. DOI: https://doi.org/10.4103/1658-354X.179094

Kim MC, Fricchione GL, Akeju O. Accidental awareness under general anaesthesia: Incidence, risk factors, and psychological management. British Journal of Anaesthesia Education. 2021 Apr; 21(4): 154-61. doi: 10.1016/j.bjae.2020.12.001. DOI: https://doi.org/10.1016/j.bjae.2020.12.001

Yusefzadeh H, Didarloo A, Nabilou B. Provider knowledge and performance in medication injection safety in anesthesia: A mixed method prospective crosses sectional study. Plos one. 2018 Dec; 13(12): e0207572. doi: 10.1371/journal.pone.0207572. DOI: https://doi.org/10.1371/journal.pone.0207572

Zha C, Che X, Xiong L, Ji Y, Zhang G. Knowledge, Attitude, and Practice of Anesthetists in Managing Severe Craniocerebral Trauma in China: A Cross-Sectional Study. International Journal of General Medicine. 2025 Dec: 1035-46. doi: 10.2147/IJGM.S508924. DOI: https://doi.org/10.2147/IJGM.S508924

Cascella M, Fusco R, Caliendo D, Granata V, Carbone D, Muzio MR et al. Anesthetic dreaming, anesthesia awareness and patient satisfaction after deep sedation with propofol target controlled infusion: A prospective cohort study of patients undergoing day case breast surgery. Oncotarget. 2017 Apr; 8(45): 79248. doi: 10.18632/oncotarget.17238. DOI: https://doi.org/10.18632/oncotarget.17238

Echeverry-Marín PC, Arévalo J, Pinzón P, Vanegas-Saavedra A, Leguizamón M. Uso de la anestesia total intravenosa en Colombia: encuesta nacional dirigida a anestesiólogos activos en Colombia. Revista Colombiana de Anestesiología. 2017 Apr; 45(2): 122-7. doi: 10.1016/j.rca.2017.02.005. DOI: https://doi.org/10.1016/j.rca.2017.02.005

Kumar KS and Sebastian J. Neuroanaesthesia: should volatile anaesthetics or total intravenous anaesthesia be used?. British Journal of Hospital Medicine. 2022 May; 83(5): 1-2. doi: 10.12968/hmed.2022.0150. DOI: https://doi.org/10.12968/hmed.2022.0150

Obara S, Kamata K, Nakao M, Yamaguchi S, Kiyama S. Recommendation for the practice of total intravenous anesthesia. Journal of Anesthesia. 2024 Dec; 38(6): 738-46. doi: 10.1007/s00540-024-03398-2. DOI: https://doi.org/10.1007/s00540-024-03398-2

Dadoo F, Scribante J, Perrie H, Welch E. Total intravenous anaesthesia: a survey of practices and training at an anaesthesiology department. Southern African Journal of Anaesthesia and Analgesia. 2023 Apr; 29(1): 32-7. doi: 10.36303/SAJAA.2760. DOI: https://doi.org/10.36303/SAJAA.2760

Fentie Y and Simegnew T. Awareness and its associated factors towards anesthesia and anesthetists' among elective surgical patients in Debre Tabor Comprehensive Specialized Hospital, North Central Ethiopia 2021: Cross-sectional study. Annals of Medicine and Surgery. 2021 Aug; 68: 102640. doi: 10.1016/j.amsu.2021.102640. DOI: https://doi.org/10.1016/j.amsu.2021.102640

Najeeb M, Ahmad M, Mailk S, Tayyab M, Asad MT, Ali S. Awareness with Recall During General Anesthesia: A Cross-Sectional Study. Pakistan Journal of Medicine and Dentistry. 2024 Jul; 13(3): 106-14. doi: 10.36283/PJMD13-3/015. DOI: https://doi.org/10.36283/PJMD13-3/015

Fischer D, Edlow BL, Giacino JT, Greer DM. Neuroprognostication: a conceptual framework. Nature Reviews Neurology. 2022 Jul; 18(7): 419-27. doi: 10.1038/s41582-022-00644-7. DOI: https://doi.org/10.1038/s41582-022-00644-7

Tasbihgou SR, Vogels MF, Absalom AR. Accidental awareness during general anaesthesia–a narrative review. Anaesthesia. 2018 Jan; 73(1): 112-22. doi: 10.1111/anae.14124. DOI: https://doi.org/10.1111/anae.14124

Arevalo JJ, Pinzon PA, Echeverry P, Botero MT, Vanegas A. Abstract PR066: Training in Total Intravenous Anesthesia in Colombia: A Nation-Wide Survey. Anesthesia & Analgesia. 2016 Sep; 123(3S): 96. doi: 10.1213/01.ane.0000492475.76631.92. DOI: https://doi.org/10.1213/01.ane.0000492475.76631.92

Hill M, Peat W, Courtman S. A national survey of propofol infusion use by paediatric anaesthetists in Great Britain and Ireland. Pediatric Anesthesia. 2008 Jun; 18(6): 488-93. doi: 10.1111/j.1460-9592.2008.02459.x. DOI: https://doi.org/10.1111/j.1460-9592.2008.02459.x

Ranta SO, Laurila R, Saario J, Ali-Melkkila T, Hynynen M. Awareness with recall during general anesthesia: incidence and risk factors. Anesthesia & Analgesia. 1998 May; 86(5): 1084-9. doi: 10.1097/00000539-199805000-00035. DOI: https://doi.org/10.1097/00000539-199805000-00035

Yu H and Wu D. Effects of different methods of general anesthesia on intraoperative awareness in surgical patients. Medicine. 2017 Oct; 96(42): e6428. doi: 10.1097/MD.0000000000006428. DOI: https://doi.org/10.1097/MD.0000000000006428

Priyadharsini K S, Haldar N, Prasad T K, Ramanna MK, Annamalai M. An Observational Study on the Intraoperative Awareness Following General Anesthetic Drugs. Journal of Pharmacology and Pharmacotherapeutics. 2023 Mar; 14(1): 47-53. doi: 10.1177/0976500X231172579. DOI: https://doi.org/10.1177/0976500X231172579

Alnemri A, Sussman S, Estephan L, Hamilton C, Stewart M, Zhan T et al. Cost of total intravenous anesthesia versus inhalation anesthesia in obstructive sleep apnea surgery. The Laryngoscope. 2022 Jul; 132(7): 1487-94. doi: 10.1002/lary.30094. DOI: https://doi.org/10.1002/lary.30094

Estephan LE, Sussman S, Stewart M, Zhan T, Thaler A, Boon M et al. Total intravenous anesthesia versus inhaled sevoflurane in obstructive sleep apnea surgery: A randomized controlled trial. The Laryngoscope. 2023 Apr; 133(4): 984-92. doi: 10.1002/lary.30438. DOI: https://doi.org/10.1002/lary.30438

Knutsson P, Mourougane A, Pazos R, Schmidt J, Palermo F. Nowcasting TiVA indicators. OECD Statistics Working Papers; 2023 May.

Bajwa SJ, Vinayagam S, Shinde S, Dalal S, Vennel J, Nanda S. Recent advancements in total intravenous anaesthesia and anaesthetic pharmacology. Indian Journal of Anaesthesia. 2023 Jan; 67(1): 56-62. doi: 10.4103/ija.ija_1022_22. DOI: https://doi.org/10.4103/ija.ija_1022_22

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Published

2025-02-28

How to Cite

Tariq, M., Zaman, B., Khan, M. A., Rabbani, S., Khalid, ., & Qureshi, F. A. (2025). Prevalence of Awareness in Total Intravenous Anesthesia: A Cross-Sectional Study: Awareness in Total Intravenous Anesthesia. Pakistan Journal of Health Sciences, 6(2), 108–113. https://doi.org/10.54393/pjhs.v6i2.2772

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