One may wish to use total intravenous anaesthesia to reduce the pollution hazard in the operating theatre, to avoid repeating the administration of potentially toxic drugs, or for specific indications where the inhalational technique is unsuitable. It may eventually become the method of choice where sophisticated modern equipment is not available, but as yet we have not progressed sufficiently with our understanding or our investigation of the technique to recommend it as a routine outside major centres. To most anaesthetists total intravenous anaesthesia means the administration of barbiturates or other induction agents throughout the period of anaesthesia, supplemented by a myoneural blocking drug and possibly with a potent narcotic and combining these with the continuous use of nitrous oxide/oxygen. Our knowledge of potent narcotics has increased dramatically in the last few years and, while we include high doses of analgesics under this heading, it is not always appreciated that nitrous oxide can be dispensed with while the patient is breathing oxygen-enriched air. This simplifies the method. For more than three decades anaesthetists have been using balanced anaesthesia, based on a drug which will induce sleep, one which will produce muscular paralysis and an analgesic or other means of suppressing reflex response to the operation. This has certainly achieved worldwide acceptance and there is no reason why the same principles should not apply to total intravenous anaesthesia.