How Culture Enables Practice: Facilitators and Barriers to the Use of Total Intravenous Anesthesia in Pediatric Anesthesia
Authors' conclusion
Training in a TIVA institution can have a profound effect on using TIVA in children and drive changes in anesthetic practice elsewhere.
Study context
- Population
- Current and former British Columbia Children's Hospital (BCCH) anesthesiologists and trainees11 interviewed
- Participants
- 26 participants
- Outcome
- Effect of BCCH total intravenous anesthesia (TIVA) experience on participants' anesthetic practice (survey)
Methodological detailssemi-structured interviews, deductive and inductive thematic analysis, single institution (BCCH), 21 attending physicians, 2 fellows, 3 residents; 58% <10 and 23% >20 years' practice, 92% academic setting; median [IQR] 400 [200-500] children annually
- Semi-structured interviews
- Deductive and inductive thematic analysis
- Single institution (BCCH)
- 21 attending physicians, 2 fellows, 3 residents; 58% <10 and 23% >20 years' practice
- 92% academic setting; median [IQR] 400 [200-500] children annually
Main finding
As reported in the abstract
- BCCH experience had changed their practice
- 96%
- Changes influenced by positive experience
- 77%
- Changes influenced by supportive environment
- 42%
- Changes influenced by scientific evidence
- 42%
- Technique choice depended on patient factors
- 89%
- Technique choice depended on institutional expectations
- 46%
- Technique choice depended on pharmacology
- 42%
- Technique choice depended on patient preference
- 39%
- Technique choice not dependent on parental preference
- 15%
Observational data: associations, not effects.
Further findings
Interview themes
- Intervention bundles, expectation-setting, family education, equipment and staff availability, supportive workflows
Original publication
How Culture Enables Practice: Facilitators and Barriers to the Use of Total Intravenous Anesthesia in Pediatric Anesthesia. Paediatr Anaesth. Published 11 May 2026. doi:10.
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