Conclusions
There is a much larger body of literature and wider experience worldwide with inhalation anaesthesia, i.e. with the use of sevoflurane in the last 5 years, in children compared to TIVA. Moreover, propofol is still not licensed for use in small children, with age restrictions varying from country to country, and it is difficult from the literature alone to assess the frequency of use of TIVA in paediatric anaesthetic practice. Non-paediatric anaesthesiologists find inhalation anaesthesia easier to use and therefore safer for patients. TIVA in paediatric anaesthesia could be a valid alternative to inhalation agents, but its administration certainly requires a deeper knowledge of the drug’s pharmacokinetic and the physiology of children. Even though the problem of awareness seems to be less relevant than in the past, there is at themoment no reliable technique for monitoring plasma concentration of the drugs used with intravenous anaesthesia, and an increased risk of awareness with TIVA, especially with the concurrent use of muscle relaxants, has been cited as a possible drawback to its use.