What methods can be used to maintain anesthesia?

• A. Inhalational anesthesia
• B. Intravenous anesthesia
• C. IV, inhalation, TIVA, or multimodal
• D. Spinal anesthesia only

Answer: (C)

Maintaining anesthesia after induction can be achieved through several approaches, not just one. You can keep depth of anesthesia with inhaled volatile agents, with intravenous infusions of anesthetic drugs, or with total intravenous anesthesia (TIVA) that uses IV drugs only. A multimodal plan combines different agents and techniques—for example, using regional analgesia alongside low-dose general anesthesia—to control depth while reducing side effects and improving analgesia. The best answer is the one that includes all these valid methods, reflecting the real practice that anesthesiologists tailor maintenance to the patient and procedure. Inhalation alone doesn’t cover IV or TIVA, and regional techniques like spinal anesthesia aren’t used to maintain general anesthesia by themselves, so they don’t represent the full set of maintenance options.