Thirty patients undergoing laparoscopic gynaecological sterilization, as day-cases, were randomly allocated to receive either total intravenous anaesthesia (TIVA) with a propofol and alfentanil mixture or a standard inhalational technique. Immediate recovery, as measured by times to awakening, co-operation and orientation, and psychomotor recovery, as measured by 'P' deletion studies, were not significantly different between the two groups. TIVA produced a significant reduction in post-operative nausea at both 1 and 2 h post-operatively, as measured by a visual analogue scale (P < 0.01). No patient in the TIVA group vomited whereas two vomited in the inhalational group. There were no differences between the two groups with respect to suitability for discharge home and no incidences of awareness. We conclude that TIVA with a propofol and alfentanil mixture provides satisfactory anaesthesia for gynaecological sterilization, with good recovery characteristics and a low incidence of post-operative nausea and vomiting.