Indian journal of anaesthesia
August 20, 2026 · via Europe PMC
Quantifying carbon dioxide emissions in paediatric anaesthesia practice: The impact of volatile anaesthetic choice: A prospective, randomised, single-blinded comparative study.
Pant S, Jindal P, Chauhan AK.
AI summary — for doctors, generated from the abstract only
In a small randomised trial of children undergoing elective surgery with supraglottic airways, sevoflurane produced markedly lower agent consumption and carbon dioxide-equivalent emissions than desflurane, with similar haemodynamic stability and depth of anaesthesia.
What was studied
A prospective, randomised, single-blinded comparison of sevoflurane versus desflurane in 50 ASA I-II children aged 3-12 years undergoing elective surgery with second-generation supraglottic airways (25 per group), measuring agent consumption and CO2-equivalent emissions using the Dr. Tom Pierce anaesthetic gas calculator.
Key findings
- Mean agent consumption was lower with sevoflurane (28.39 ± 15.88) than desflurane (49.30 ± 0.29).
- Mean CO2 emission was far lower with sevoflurane (3.68 ± 2.02) than desflurane (100.55 ± 74.68).
- Haemodynamic stability and bispectral index-monitored depth of anaesthesia were reported as consistent between groups.
Clinical relevance
The findings suggest that choosing sevoflurane over desflurane for maintenance in similar paediatric cases could meaningfully reduce the environmental footprint of anaesthesia without an apparent trade-off in haemodynamic stability, which may be relevant to departments considering sustainability initiatives.
Who should care
Limitations
Single-centre study with a small sample (n=25 per group); no p-values were reported for the emissions comparison in the abstract, and the abstract itself states that further multicentre validation is needed.
Sevoflurane cut carbon emissions far more than desflurane in a small paediatric trial, with comparable clinical stability.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Background and aims
Carbon foot printing provides a metric for the environmental burden-energy, waste, and potent greenhouse emissions-inherent in our daily clinical practice. This study quantifies and compares the carbon dioxide (CO2)-equivalent emissions of sevoflurane versus desflurane in paediatric patients using the validated Dr. Tom Pierce anaesthetic gas calculator.
Methods
Fifty American Society of Anesthesiologists physical status I-II children aged between 3 and 12 years of either gender with no congenital anomalies undergoing elective surgery with second-generation supraglottic airways were prospectively evaluated. Patients were randomised into Group S (Sevoflurane, n = 25) or Group D (Desflurane, n = 25). Environmental impact was calculated based on real-time consumption data using Dr Tom Pierce's anaesthetic gases calculator application.
Results
While haemodynamic stability and bispectal index-monitored depth remained consistent across both cohorts, the ecological divergence was profound. The mean agent consumption was significantly lower in the S group (28.39 ± 15.88) as compared to the D group (49.30 ± 0.29). Most strikingly, the mean CO2 emission for sevoflurane (3.68 ± 2.02) was a mere fraction of the impact seen with desflurane (100.55 ± 74.68), representing a massive reduction in the global warming potential per case.
Conclusion
Sevoflurane demonstrated a significantly lower carbon footprint than desflurane. Given that clinical outcomes and haemodynamic stability remained consistent across cohorts, the transition to sevoflurane-based maintenance represents a high-impact, actionable intervention for sustainable paediatric practice. These findings advocate the preferential use of sevoflurane as the primary volatile agent in "green anaesthesia" protocols, though further multicentre validation is required to solidify these environmental benchmarks.
DOI
10.4103/ija.ija_1690_25
PMID
42719911
PMCID
PMC13557721
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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