Total intravenous anesthesia (TIVA) has clinical and pivotal environmental advantages compared to chlorofluorocarbon- and hydrofluorocarbon-based inhalational anesthesia. Therefore, there is an ongoing paradigm shift from inhalational anesthesia to TIVA, advocated by ESAIC & ASA, and many hospitals across Europe have completely phased out inhalational anesthesia with the added advantage of eliminating occupational exposure to volatile agents.