All true about total intravenous anesthetics (TIVA) except-
Awareness is a significant problem associated with TIVA though mostly due to device problem. TIVA with propofol offers some impoant advantages over inhalation anesthetics, including Smooth induction and rapid recovery with minimal hangover and a low incidence of nausea and vomiting Can be safely used in the patient susceptible to malignant hyperpyrexia Reduction in operation theatre pollution and thus the green house effect of inhalational anesthesia The paralysis is not always required, avoiding reversal agents and emergence is rapid (especially when propofol TIVA is used with remifentanil).
The best combination of TIVA is Propofol + Remifentanil
TIVA has better recovery profile with reduced risk of post-operative nausea + vomiting
It can be used safety in patients with risk of malignant hypehermia
There is no evidence of awareness with TIVA
Intravenous Anesthetic Agents