The science behind TCI-TIVA — a safer, cleaner, smarter anaesthesia that is taking over operation theatres
Anaesthesia is the backbone of modern surgery. It makes painless operations possible, from small procedures to major life-saving surgeries. Traditionally, anaesthesia is given using gases through specialised machines. But a new, smarter method is rapidly taking its place — TIVA, or Total Intravenous Anaesthesia, especially when used with TCI, or Target-Controlled Infusion. This method is safer for patients and for the planet — and it's already changing lives in Indian hospitals.
What is TCI-TIVA?
In simple terms, TIVA means putting you to sleep using medicines injected through an intravenous (IV) line, instead of gases you inhale. TCI is a smart system that controls how these medicines are delivered. It uses computerised calculations and infusion pumps to maintain the exact level of sleep and comfort your body needs — adapting in real time. Think of it like an autopilot for anaesthesia — precise, responsive, and reliable.
Why is this technique revolutionary? TCI aids in greater safety and accuracy. It uses advanced pharmacological models to calculate the right dose based on your body, age, and health status. This avoids issues like under- or over-dosing, unstable blood pressure, or delayed recovery. It also aids in faster and clearer recovery, with patients under TIVA often waking up faster, more alert, and with less nausea or vomiting. This is particularly beneficial for same-day surgeries or when you want to get back to normal quickly. From infants to the elderly, TIVA is gentle and effective. It doesn't rely on your lungs or airways, so it's safer for people with asthma, allergies, or lung issues.
No gas also means no pollution: traditional anaesthesia uses gases that are released into the atmosphere after use. These gases are potent greenhouse contributors, some thousands of times more harmful than carbon dioxide. In contrast, TCI-TIVA does not release any gases, making it a green anaesthesia technique. It's safer for the planet — and cleaner for the surgical team and patient alike. Operating rooms using traditional gases contribute thousands of tons of greenhouse gases every year. One study estimated that replacing just one patient's gas-based anaesthesia with TCI-TIVA saved the equivalent of 500 km of car emissions. If even half the hospitals in India adopt this change, the environmental impact would be enormous.
The science behind TCI-TIVA
Modern TCI machines are highly advanced. They use real-time feedback from brain-monitoring tools like the BIS (Bispectral Index) by measuring and controlling anaesthesia depth. They deliver exact doses tailored to minute-by-minute needs. They also help reduce human error through safety alerts and pre-set drug libraries. TCI machines have touchscreen interfaces for user-friendly control by anaesthesia providers. This means better safety, quicker adjustments, and peace of mind for both doctors and patients.
What medicines are used? TCI-TIVA uses well-researched, safe, and fast-acting drugs. These include:
Propofol – Helps you sleep quickly and wakes you up smoothly. Also reduces nausea.
Remifentanil – A short-acting painkiller that wears off fast, allowing quick recovery.
Dexmedetomidine – Adds calmness, reduces anxiety, and maintains stable heart rate and breathing.
These drugs are delivered precisely through an IV line — no mask, no gas, and in many cases, no breathing tube either.
For patients, this method offers a dramatically improved experience, with no strong-smelling gases or uncomfortable masks. There is also no sore throat in many cases (especially when tubes are avoided). It aids faster return to alertness and normal activities. There are also lower chances of post-surgery dizziness or vomiting. This makes day-care surgeries, dental procedures, and even major surgeries easier and more pleasant.
Is it available in India? Yes. TCI-TIVA is already in use in leading private and government hospitals, particularly in cities like Delhi, Mumbai, Chennai, Bengaluru, Hyderabad and all other metros and sub metro cities of India. Indian-made TCI devices have also entered the market, making the technology more cost-effective and accessible. Anaesthesiologists across India are being trained in this method, and more centres are adopting it every month.
Is it the right option for everyone?
In most cases, yes with all sex, age and weight patients. The decision however depends on: the type of surgery, the patient's medical history, the availability of TCI machines and the experience of the anaesthesia team. It is important to ask your doctor or anaesthesiologist about TCI-TIVA as an option before surgery.
As a patient or family member, it is your right to be informed about all available and safe medical options. TCI-TIVA is not just a new technique — it is a safer, cleaner, and smarter way to experience anaesthesia. Just like you ask about the surgeon or the hospital, you can now ask: Can I have TCI-TIVA?
TCI-TIVA represents the future of anaesthesia — not just for hospitals and doctors, but for you, the patient. It is cleaner for the planet, safer for your body, smarter for medical teams, and more comfortable for your surgical journey. This technology has already changed many operating rooms — and could soon change your surgical experience too. When it comes to your health, you deserve the best. And that means knowing and understanding the silent revolution taking place in the world of anaesthesia.
(Dr. Tushar Chokshi is a privately practicing anaesthesiologist based in Vadodara, Gujarat. chokshitushar@hotmail.com)
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