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The mysterious origins of TIVA anesthesia: Why is the 1872 chlorohydrin compound a cause for concern?
Total Intravenous Anesthesia (TIVA) is an intravenous anesthetic that is given to the patient to induce a temporary loss of sensation or consciousness. Since TIVA was first studied using chlorohydrin compounds in 1872, the technique has undergone considerable development. TIVA is becoming increasingly popular as an alternative to general anesthesia in today's medical procedures, aiming to improve recovery after surgery.
“Advances in TIVA technology allow physicians to better control the depth and effectiveness of anesthesia, thereby improving patient safety and comfort.”
In the history of TIVA, we go back to the mid-1800s, when the medical community began to explore the possibilities of intravenous anesthesia. In 1845, Francis Rynd invented the hollow needle, which made intravenous injection of drugs possible. Following the invention of the syringe by Charles Gabriel Pravaz in 1853, more chemical compounds were tested as intravenous anesthetics. Among them, Pierre-Cyprien Oré first reported the use of chlorohydrin hydrate for intravenous anesthesia in 1872, but it was accompanied by a high mortality rate, which was a challenge that could not be ignored in the cases at that time.
With the advancement of technology, the demand for anesthetics in the medical field continues to increase. Although Hedonal, developed in 1909, is commonly used for general anesthesia, it has not been widely promoted due to its long duration and limited effectiveness. Over time, many new intravenous anesthetics have come into being, such as alcohols and magnesium sulfate, which have gradually replaced early anesthetics. With the introduction of propofol in 1986, the future of intravenous anesthesia changed. Propofol has a clear pharmacological profile and is widely used for various medical purposes.
"Propofol is considered one of the best and safest intravenous anesthetics, favored by the medical community for its rapid onset of action and few adverse reactions."
TIVA has many advantages over traditional inhalation anesthesia. It can induce general anesthesia more safely and effectively, especially in high-risk patients, and avoids the possible dangers of inhalation anesthesia. The application of TIVA has further demonstrated its value in some trauma rescue situations, such as serious accidents, natural disasters and wars.
"Smooth anesthesia induction" and "rapid postoperative recovery" are several main goals of TIVA application. According to the latest data, propofol-based TIVA not only improves the comfort of postoperative recovery, but also effectively reduces nausea and vomiting, increases the speed of discharge, and maintains good hemodynamic stability. Despite this, TIVA currently accounts for a small proportion of general anesthesia, one reason being the relatively high cost of its preparation and maintenance.
The dosage of TIVA requires careful assessment of the individual patient's condition, taking into account differences in pharmacokinetics and pharmacodynamics, especially in patients with impaired renal or liver function or abnormal myocardial function. Appropriate anesthetic dosage directly affects patient safety. I believe that the medical team’s thorough understanding of different medical conditions will make the application of TIVA safer and more effective.
“TIVA requires more caution when considering special groups, such as obese, elderly and pediatric patients.”
Although TIVA has many advantages, it is also associated with various risks, such as anesthesia awakening, hypersensitivity, and neurotoxicity, which require special attention in obese, elderly and pediatric patients. However, with the continuous advancement of clinical technology and the improvement of related equipment, it is expected that these risks can be further reduced in the future.
Overall, the development of TIVA can be regarded as an important milestone in its history. Its origin and development reflect the medical community's emphasis on and progress in anesthesia technology. As we gain a better understanding of the effects and risks of anesthetics, how will TIVA develop in the future and affect the way we administer anesthesia?
