Anesthesiology · 2026
Greenhouse Gas Emissions of Sevoflurane Outweigh Those of Carrier Gas and Carbon Dioxide Absorbers across the Fresh Gas Flow Spectrum.
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Jouwena Jennifer, De Wolf Andre M, Hendrickx Thomas J, Hendrickx Jan F A
Аннотация
BACKGROUND: The absolute and relative effects of lowering fresh gas flows (FGFs) on the carbon dioxide equivalent (CO 2 e) emissions of sevoflurane, carrier gases (oxygen/air) and prepacked carbon dioxide canister remain poorly quantified. The authors quantified these factors across a 0.2 to 4-l/min FGF range during the first hour of anesthesia.
METHODS: Data were compiled from three studies including 132 American Society of Anesthesiologists (Schaumburg, Illinois) Physical Status I to III patients receiving a constant end-tidal sevoflurane concentration (FETsevo) using manual (n = 50) or target-controlled delivery (n = 48) with 0.2 to 4 l/min FGF or during automated closed-circuit delivery (n = 34). Sevoflurane consumption was normalized to both 1.3 and 2.0% FETsevo, and carrier gas use to an inspired oxygen concentration of 30% and 60%. Prepacked carbon dioxide absorbent usage was calculated using a previously described model for both 130 and 160 ml/min carbon dioxide output ( ). Published CO 2 e values were used to derive CO 2 e of sevoflurane.
RESULTS: Sevoflurane CO 2 e increases linearly with FGF (range, 2.4 to 18.6 kg CO 2 e), except when a brief wash-in period was used due to low FGF (FGF less than 1 l/min). Carrier gas CO 2 e decreases with lower FGF but in a more complex manner, and increases with higher inspired oxygen concentration (range, 0.010 to 0.124 kg CO 2 e). Absorbent CO 2 e decreases linearly with FGF (range, 0 to 0.070 kg CO 2 e). The CO 2 e of sevoflurane is two orders of magnitude higher than CO 2 e of carrier gas and carbon dioxide absorbent, which are similar.
CONCLUSIONS: When delivering sevoflurane in oxygen/air, the CO 2 e contribution of the carrier gas and carbon dioxide absorbent is less than 3%, even during closed-circuit delivery. While CO 2 e is only one element of a comprehensive life cycle analysis, the presented CO 2 e data underscore that the key to minimizing the global warming potential of sevoflurane is lowering FGF and decreasing FETsevo.
METHODS: Data were compiled from three studies including 132 American Society of Anesthesiologists (Schaumburg, Illinois) Physical Status I to III patients receiving a constant end-tidal sevoflurane concentration (FETsevo) using manual (n = 50) or target-controlled delivery (n = 48) with 0.2 to 4 l/min FGF or during automated closed-circuit delivery (n = 34). Sevoflurane consumption was normalized to both 1.3 and 2.0% FETsevo, and carrier gas use to an inspired oxygen concentration of 30% and 60%. Prepacked carbon dioxide absorbent usage was calculated using a previously described model for both 130 and 160 ml/min carbon dioxide output ( ). Published CO 2 e values were used to derive CO 2 e of sevoflurane.
RESULTS: Sevoflurane CO 2 e increases linearly with FGF (range, 2.4 to 18.6 kg CO 2 e), except when a brief wash-in period was used due to low FGF (FGF less than 1 l/min). Carrier gas CO 2 e decreases with lower FGF but in a more complex manner, and increases with higher inspired oxygen concentration (range, 0.010 to 0.124 kg CO 2 e). Absorbent CO 2 e decreases linearly with FGF (range, 0 to 0.070 kg CO 2 e). The CO 2 e of sevoflurane is two orders of magnitude higher than CO 2 e of carrier gas and carbon dioxide absorbent, which are similar.
CONCLUSIONS: When delivering sevoflurane in oxygen/air, the CO 2 e contribution of the carrier gas and carbon dioxide absorbent is less than 3%, even during closed-circuit delivery. While CO 2 e is only one element of a comprehensive life cycle analysis, the presented CO 2 e data underscore that the key to minimizing the global warming potential of sevoflurane is lowering FGF and decreasing FETsevo.