TIVA (total intravenous anaesthesia) is a way of giving a general anaesthetic entirely through a drip in your vein, rather than using anaesthetic gases to keep you asleep. Many patients find it gives a smoother wake-up with less sickness. For some cosmetic procedures, including Motiva Preservé breast augmentation, sedation with local anaesthetic is another option that allows you to stay awake but relaxed.
The main types of anaesthesia
- Local anaesthetic: numbing medicine is injected into the area being treated. You are fully awake. Suited to small procedures such as mole removal, earlobe repair or upper eyelid surgery.
- Sedation with local anaesthetic: you are given medicine through a drip that makes you calm and drowsy while the area is numbed. You breathe for yourself and can often respond to voices. Sometimes described as ‘awake’ surgery.
- General anaesthetic with gases: you are put to sleep with intravenous medicine, then kept asleep by breathing a carefully controlled anaesthetic vapour.
- TIVA: a general anaesthetic in which both the start and the maintenance of sleep are delivered by a computer-controlled pump into a vein, with no anaesthetic vapour.
How TIVA works
With TIVA, the anaesthetist uses a syringe pump programmed with your age, weight and other details. The pump delivers a continuous, precisely adjusted dose to keep you asleep and pain-free throughout surgery. Your breathing is supported and your oxygen levels, heart rhythm, blood pressure and depth of anaesthesia are monitored continuously. When the operation ends, the pump is switched off and you wake gradually over several minutes. TIVA is given only by consultant anaesthetists, who are doctors with specialist training.
Potential advantages of TIVA
Many anaesthetists and patients like TIVA because it is associated with less nausea and vomiting after surgery, a clear-headed wake-up and a smooth return to eating and drinking. It can be particularly helpful for people who have been very sick after a previous general anaesthetic, and it avoids anaesthetic gases, which is relevant for a small number of patients with specific inherited conditions. It is not better for everyone, and the choice between TIVA and a gas-based technique is made by the anaesthetist together with you.
Sedation and awake breast augmentation
Motiva Preservé breast augmentation is designed around a short incision and gentle, limited dissection. Because of this, many patients can have the procedure under local anaesthetic with sedation rather than a full general anaesthetic. You are relaxed and comfortable, the area is numbed thoroughly, and some patients sit up briefly during surgery so the result can be checked. Recovery from sedation is often quick. A general anaesthetic, which may be delivered as TIVA, remains available for those who prefer to be fully asleep.
Preparing for your anaesthetic
You will complete a health questionnaire and may have a pre-assessment with a nurse, including blood tests or a heart tracing if needed. Tell the team about all your medicines, supplements and allergies, previous anaesthetics and any family history of anaesthetic problems. You will be given clear fasting instructions: usually no food for six hours before surgery, with clear fluids allowed until closer to the time. Stopping smoking and vaping well in advance reduces breathing and wound problems. Some medicines, including weight-loss medication, may need to be paused beforehand, so follow the team’s advice closely.
Risks of anaesthesia
Modern anaesthesia in a properly equipped hospital is very safe for healthy adults, but no anaesthetic is risk-free. Common, short-lived effects include a sore throat, feeling sick, shivering, drowsiness and bruising where the drip was placed. Less common problems include a reaction to a medicine, breathing difficulties or, rarely, awareness during a general anaesthetic, which depth monitoring helps to reduce. Any surgery increases the risk of blood clots, which is why you may wear compression stockings and be encouraged to walk soon afterwards. Serious complications are rare, and your anaesthetist will discuss your individual risk with you.
After you go home
You must not drive, drink alcohol, sign legal documents or make important decisions for 24 hours after sedation or a general anaesthetic. An adult should take you home and stay with you overnight. Call 999 for chest pain or breathlessness, and contact NHS 111 or your GP the same day for sudden one-sided leg swelling or calf pain.
Frequently Asked Questions
Is TIVA the same as sedation?
No. TIVA is a full general anaesthetic, so you are completely asleep. Sedation keeps you drowsy and relaxed but you continue breathing on your own.
Is TIVA safer than gas anaesthesia?
Both are safe in experienced hands. TIVA is often chosen to reduce sickness after surgery, but the right technique depends on you and the operation.
Can patients choose TIVA?
You can discuss your preference with the anaesthetist, who will recommend the technique best suited to your health and the procedure.
Is anything felt during awake breast augmentation?
The area is thoroughly numbed and sedation helps you relax. You may feel pressure or movement, but the aim is for you to be comfortable throughout.
How long does it take to recover from the anaesthetic?
Most people feel reasonably alert within a few hours, though you should rest and avoid driving for at least 24 hours.
