NAPs and TIVA and pEEG monitoring

Quick summary 🧵 for amongst others
Julian Fuller

NAP5
Awareness
-TIVA was associated with a doubling in frequency of accidental awareness (during general anaesthesia (AAGA)
-what a lot of people missed was that when TIVA was used

In NAP6 (anaphylaxis) we took stock of all drugs used during anaesthesia

-use of TIVA rose to 8%
-pEEG monitoring was used in 12%
*rising to 32% with TIVA
*38% with TIVA + NMB
-with variation by specialty, anaesthetist seniority & BMI

rcoa.ac.uk/sites/default/…

2/5

In NAP7 (perioperative cardiac arrest) we collected data on TIVA & pEEG use but not on NMB use

-TIVA use rose dramatically to 26%
*a 4-fold rise in a decade
-pEEG rose to 19%
*a 7-fold rise
-pEEG use during TIVA rose to 62% (likely close to 100% during TIVA + NMB though

In the registry phase of NAP7 a common theme was of isolated severe hypotension or leading to perioperative cardiac arrest.

This related to patients who were high risk from
-old age
-frailty
-high ASA
-acute disease processes

Within this cohort both propofol & TIVA with