Propofol Reduces Long-Term Water Contamination Compared to Sevoflurane

The selection of a maintenance anesthetic agent typically hinges on balancing recovery speed against the risk of perioperative complications. In pediatric populations, sevoflurane is associated with slightly faster extubation times (mean difference -1.42 minutes; 95% CI, -1.81 to -1.02) compared to propofol [1, 2]. However, propofol-based total intravenous anesthesia (a technique using continuous intravenous infusion rather than inhaled gases) significantly reduces the risk of emergence agitation (OR 0.25; 95% CI, 0.16 to 0.39) and postoperative nausea and vomiting [3, 4]. Beyond these immediate outcomes, research suggests that volatile agents may influence long-term cancer survival [5] and can significantly prolong the recovery of neuromuscular blockade, with sevoflurane extending rocuronium duration to 136 minutes compared to 61.5 minutes with propofol in infants (p < 0.001) [6]. As healthcare systems increasingly prioritize sustainability, the clinical focus is expanding beyond immediate patient recovery to the environmental footprint of the operating room. A retrospective modeling study now examines how these common anesthetic choices contribute to persistent ecological contamination, offering physicians new data to weigh when selecting an anesthetic plan.