Anaesthetic drugs & techniques
Total Intravenous vs Volatile Inhalational Anesthesia for Major Noncardiac Surgery: A Randomized Clinical Trial
Primary resultResult — go to the resultIncidence rate ratio 1.00 95% CI 0.99–1.02Authors' conclusion
Among older adults undergoing major noncardiac surgery, TIVA did not improve days alive and at home at 30 days compared with inhalational anesthesia.
Study context
- Population
- Patients aged 50 years or older scheduled for elective major noncardiac surgery, 49 UK NHS hospitals, January 2022 to April 2024randomized
- Participants
- 2,508 patients
- Comparison
- Total intravenous anesthesia (TIVA) vs volatile-based inhalational anesthesia for maintenance of GA
- TIVAn = 1,254
- Inhalational anesthesian = 1,254reference
- Primary endpoint
- Days alive and at home
- Follow-up
- 30 days
Methodological detailspragmatic, multicentre, open-label
- Pragmatic
- Multicentre
- Open-label
Primary result
As reported in the abstract
Incidence rate ratio
1.00
95% CI 0.99–1.02
adjusted P = .68
By group
TIVA vs Inhalational anesthesia
IRR 1.00 (95% CI 0.99–1.02); adjusted P = .68
Secondary outcomes
Days alive and at home at 90 days; mortality at 30 days, 90 days, 6 months; QoR-15 at day 3
- No differences between groups
Thirst, hoarseness, and nausea and vomiting
- Lower rates reported in the TIVA group
Delirium (4AT) · day 3
- Similar between groups; majority with no delirium at day 3
- 87.6%
Safety
Major postoperative complications · 30 days
- Major complications overall, no significant between-group differences
- 12.4%
Certain or probable unintentional awareness under anaesthesia
- 2 cases reported, both in the TIVA group
Thirst, hoarseness, PONV
- Lower rates in the TIVA group
Original publication
Total Intravenous vs Volatile Inhalational Anesthesia for Major Noncardiac Surgery: A Randomized Clinical Trial. JAMA. Published 22 September 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →