Evaluating the Role of Total Intravenous Anesthesia (TIVA) in Different Gastrointestinal Procedures

Author(s): Mostafa Nuruzzaman, Rajat Shuvra Das, Saiful Mahmud Tusher, Mst. Nazmunnaher Mina, Mostafa Nahian Habib, Anisur Rahman

Background: Total Intravenous Anesthesia (TIVA) is increasingly used for gastrointestinal (GI) procedures due to its favorable pharmacokinetic profile, reduced postoperative complications, and improved patient satisfaction. However, data on its role across diverse GI interventions remain limited in developing countries.

Methods: This prospective observational study was conducted from January to December 2024 at Popular Diagnostic Centre LTD, Dhaka, Bangladesh. A total of 506 adult patients (ASA I–II) undergoing elective diagnostic or therapeutic GI procedures under TIVA were enrolled. Exclusion criteria included ASA III or above, known allergies to anesthetic agents, or need for advanced airway management. Demographic data, anesthetic practices, intraoperative observations, and post-procedural outcomes were analyzed using SPSS.

Results: Among 506 patients undergoing GI procedures under TIVA, upper GI endoscopy was the most common (60.9%), followed by colonoscopy (15.6%) and combined procedures (7.9%). Propofol was used for induction in all cases, with fentanyl (63.6%) and remifentanil (36.4%) as opioids. Hemodynamic stability was maintained in 90.5% of patients, and desaturation occurred in 7.5%. Postoperative nausea/vomiting occurred in 8.1%, hypotension in 3.8%, and delayed recovery in 4.9%. Most patients (80.4%) had no complications. Unplanned hospital admission was needed in 3.0%, and high patient satisfaction was recorded in 92.5% of cases.

Conclusion: TIVA proved to be a safe, effective, and well-tolerated anesthetic technique for a variety of GI procedures, demonstrating high patient satisfaction and a low incidence of complications. Broader application and further comparative studies are warranted.