On the horns of a dilemma: choosing total intravenous anaesthesia or volatile anaesthesia

Bernhard Riedel, Julia Dubowitz, Joyce Yeung, Shaman Jhanji, Sachin Kheterpal, Michael S. Avidan

Research output: Contribution to journalEditorial

1 Scopus citations


There are two established techniques of delivering general anaesthesia: propofol-based total intravenous anaesthesia (TIVA) and volatile agent-based inhaled anaesthesia. Both techniques are offered as standard of care and have an established safety track record lasting more than 30 years. However, it is not currently known whether the choice of anaesthetic technique results in a fundamentally different patient experience or affects early, intermediate-term, and longer-term postoperative outcomes. This editorial comments on a recently published study that suggests that inhaled volatile anaesthesia might be associated with fewer postoperative surgical complications than propofol-based TIVA for patients undergoing colorectal cancer surgery. We consider the strengths and limitations of the study, place these findings in the context of the broader evidence, and discuss how the current controversies regarding anaesthetic technique can be resolved, thereby helping to bring precision medicine into the modern practice of perioperative care.

Original languageEnglish
Pages (from-to)284-289
Number of pages6
JournalBritish journal of anaesthesia
Issue number3
StatePublished - Sep 2022


  • TIVA
  • inhalational anaesthesia
  • postoperative complications
  • postoperative outcomes
  • precision medicine
  • propofol
  • total intravenous anaesthesia
  • volatile anaesthesia


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