Environmental and economic impacts of anaesthesia

Our simulations indicate that minimal flow sevoflurane produces 26.5 times more CO 2 e than TIVA, rising to 61.8 times more at 2 l min -1 FGF. TIVA also costs significantly less, at 36% and 63% of sevoflurane anaesthesia costs with minimal flow and 2 l min -1 FGF, respectively.These findings highlight not only TIVA's marked superiority in reducing carbon emissions but also its notable cost advantages over traditional volatile anaesthetic methods. The stark contrast in emissions - where TIVA produces just a fraction of the CO 2 e compared to even the most environmentally conscious sevoflurane protocols - underscores the critical role anaesthetic choice plays in healthcare sustainability. Moreover, the substantial difference in costs challenges the prevailing perception that TIVA is prohibitively expensive. As hospitals worldwide face mounting pressure to align clinical practices with environmental stewardship, these results advocate for a critical reassessment of routine anaesthetic protocols.