Paediatric TIVA and TCI

Abstract

Any drug administered will have a gradual predictable decay in concentration while surgical stimuli do not follow this predictable time course. The major difficulty with anaesthesia is to accommodate these two totally different patterns to produce rapid induction, smooth maintenance and rapid emergence in concert with the varying degrees of stimuli and patient response. At present there is no method of reliably matching the amount of drug delivered with the surgical stimulus so we have to rely on mathematical models of pharmacokinetics to determine how to give an anaesthetic hoping this is adequate for the procedure.