The propofol dose-response is the part that changes how I read the earlier trials — effectiveness climbing all the way to 100 mcg/kg/min makes the mixed results look like a dosing problem rather than a null one. Two new drugs since 2020 is also a useful reality check on how slowly this moves. Patients who had a bad time with nausea after a previous anesthetic remember it far more clearly than the pain, and it shapes what they ask about beforehand. Do the guidelines say anything about when the TIVA decision should be made for high-risk patients, or is that still left to the day?
The propofol dosing for PONV prevention was my favorite part of the new guidelines. I wish they had emphasized it more in the summary statement. The guidelines don’t make any specific recommendations about when to use TIVA.
Thanks, Tyler — that answers it. The summary statement is the part most people will actually read, so I share your wish that the propofol dosing had more room there.
The propofol dose-response is the part that changes how I read the earlier trials — effectiveness climbing all the way to 100 mcg/kg/min makes the mixed results look like a dosing problem rather than a null one. Two new drugs since 2020 is also a useful reality check on how slowly this moves. Patients who had a bad time with nausea after a previous anesthetic remember it far more clearly than the pain, and it shapes what they ask about beforehand. Do the guidelines say anything about when the TIVA decision should be made for high-risk patients, or is that still left to the day?
The propofol dosing for PONV prevention was my favorite part of the new guidelines. I wish they had emphasized it more in the summary statement. The guidelines don’t make any specific recommendations about when to use TIVA.
Thanks, Tyler — that answers it. The summary statement is the part most people will actually read, so I share your wish that the propofol dosing had more room there.