ArticleAnaesthesia2026
Cost-effectiveness analysis of total intravenous vs. inhalation anaesthesia among adults aged ≥ 50 y undergoing major non-cardiac surgery.
Article in Anaesthesia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors.
Funding
Abstract
introductionTotal intravenous and inhalational anaesthesia are used widely to maintain general anaesthesia for major non-cardiac surgery, yet their comparative cost-effectiveness remains uncertain. The VITAL trial evaluated clinical outcomes, showing no difference in days alive and at home at 30 days. We conducted an economic evaluation alongside VITAL to determine whether total intravenous anaesthesia offers an economic advantage within the UK NHS.
methodsA within-trial economic evaluation was conducted from the NHS and personal social services perspective over a 6-month time horizon. Resource use was collected from trial records and questionnaires, and health-related quality of life was measured using EuroQol five-dimension five-level instrument at baseline, discharge, 30 days and 6 months. Costs were evaluated using national sources and quality-adjusted life years were calculated using the area under the curve approach. Incremental cost-effectiveness ratios were estimated using imputed datasets, with uncertainty explored through bootstrapping and the probability of cost-effectiveness illustrated using a cost-effectiveness acceptability curve across a range of willingness-to-pay thresholds.
resultsA total of 2507 patients were allocated randomly: 1253 (50%) received total intravenous anaesthesia; and 1254 (50%) inhalational anaesthesia. Mean costs and quality-adjusted life years were similar across groups. Incremental cost was -£145 (95%CI -£1510-£1220) and incremental quality-adjusted life years -0.001 (95%CI -0.008-0.005). Total intravenous anaesthesia showed a 56-57% probability of cost-effectiveness at standard willingness-to-pay thresholds. Sensitivity analyses, including complete-case and societal-perspective models, yielded consistent findings of equivalence. DISCUSSION: Total intravenous and inhalational anaesthesia show comparable cost-effectiveness for adults aged ≥ 50 y undergoing major non-cardiac surgery. Given clinical equipoise and equivalent economic outcomes, anaesthetic choice should continue to be guided by patient factors, clinician expertise and organisational context. Further research may be justified given the large population undergoing major surgery.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.