"The Dual Benefit of TIVA-TCI: A Real-World Analysis of Economic and Environmental Superiority over Inhaled Anaesthesia".

BACKGROUND: This study compared the direct costs and environmental impact associated with two general anaesthesia techniques: Total Intravenous Anaesthesia via Target-Controlled Infusion (TIVA-TCI) and sevoflurane-based anaesthesia. METHODS: A multicentre, observational, prospective analysis of 286 surgical patients was performed, including a TIVA-TCI group (n = 216) and a sevoflurane-based anaesthesia group (n = 70). Primary endpoints included total anaesthesia cost (converted to USD) and estimated carbon footprint (kg CO₂e) per procedure. Costs were adjusted for age and weight using ANCOVA. RESULTS: TIVA-TCI was more cost-effective, with a 25.5% reduction in total adjusted anaesthesia cost ($16.61vs. $22.31; p < .001). The environmental impact was significantly lower in the TIVA-TCI group, reducing the median carbon footprint per procedure by 93.7% (1.19 kg CO₂e vs. 18.80 kg CO₂e; p < .001). Multivariate analysis confirmed the choice of technique as a significant cost predictor. CONCLUSIONS: These findings provide compelling real-world evidence supporting the adoption of TIVA-TCI as a financially and environmentally superior strategy in modern anaesthetic practice.