TIVA anesthesia and perioperative monitoring protocol

Anaesthetic Safety

KEIT DAY HOSPITAL

TIVA anesthesia and perioperative monitoring protocol

Official Manual of Clinical, Care and Organizational Protocols

1. Document Control Information

2. Scope of Application

Applicable to patients undergoing general anesthesia using the TIVA technique in the KEIT operating block.

3. Responsibilities

• Anesthesiologist: preoperative assessment, induction, maintenance, emergence and management of any complications.
• Anesthesia nurse: preparation of medications and equipment, and support with monitoring.
• Surgeon: coordination with the anesthesia team during the procedure.

4. Operating Procedure

• Confirm the patient’s identity, fasting status, allergies, anesthesia consent and airway assessment.
• Prepare medications, infusion pumps, monitors and emergency equipment before the patient enters the operating room.
• Induce anesthesia according to the individualized anesthesia plan; under the standard KEIT technique, the protocol includes propofol, fentanyl and rocuronium/norcuron for induction.
• Maintain anesthesia with a titrated continuous infusion; in the KEIT TIVA pathway, maintenance includes propofol and remifentanil infusion through dedicated pumps.
• Continuously monitor oxygenation, ventilation, circulation, temperature, clinical depth of anesthesia and hemodynamic response.
• Administer antiemetic prophylaxis and multimodal analgesia according to the individual risk profile.
• Perform extubation and transfer to recovery only after the safety criteria have been met.

5. KEIT Operational Standards

• KEIT uses total intravenous anesthesia with dedicated infusions and continuous monitoring as its reference technique.
• Infusion pumps are prepared and checked before every case.
• Prevention of postoperative nausea and vomiting is integrated into the anesthesia plan.

6. Records and Documentation

• Anesthesia record.
• Pre-use checklist for anesthesia equipment.
• Medication and infusion pump register.
• Recovery/PACU monitoring chart.

7. Review and Updates

Annual update or following review of the internal anesthesia pathway.

8. Related Attachments and Forms

• Check-list operative, moduli di registrazione, schede di audit e registri di manutenzione applicabili al presente protocollo.
• Eventuali allegati tecnici specifici di reparto o di apparecchiatura sono richiamati nelle istruzioni operative locali.

9. Final Approval