Correspondence  |   August 2016
Total Intravenous Anesthesia and Transfusion: A Double Whammy?
Author Notes
  • Northumbria Health NHS Trust, Newcastle upon Tyne, United Kingdom. sarahdawson86@gmail.com
  • (Accepted for publication March 28, 2016.)
    (Accepted for publication March 28, 2016.)×
Article Information
Correspondence
Correspondence   |   August 2016
Total Intravenous Anesthesia and Transfusion: A Double Whammy?
Anesthesiology 8 2016, Vol.125, 418-419. doi:10.1097/ALN.0000000000001175
Anesthesiology 8 2016, Vol.125, 418-419. doi:10.1097/ALN.0000000000001175
I read with great interest the article by Wigmore et al.1  at the Royal Marsden Hospital (London, United Kingdom), which suggested that total intravenous anesthesia (TIVA) is associated with improved cancer survival when compared to volatile inhalational anesthesia. The study has caused a great deal of excitement among many, and with good cause, demonstrating a 50% greater risk of mortality in the volatile group compared to TIVA.
I noticed that even after propensity matching, there was a statistically significant difference in transfusion rates between groups, there being an almost 50% higher rate of blood transfusion in the group receiving a volatile anesthetic (150 vs. 110 patients, P = 0.011). The reason for this difference is unclear; it may be that patients undergoing TIVA have lower rates of perioperative anemia, have less bleeding intraoperatively, or simply that anesthetists who use TIVA also have more conservative thresholds for blood transfusion.
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