Ecoresponsible management of anesthetic vapors

Anaesthetists must take into account the climate emergency in their management strategy. Anesthetic gases are poorly metabolized by humans; they are exhaled in unchanged form and are powerful greenhouse gases. They are characterized by their global warming power and atmospheric lifetime: sevoflurane has a global warming power at 100 years of 144, with an atmospheric lifetime of 1.4 years, whereas these values are 2590 and 14 years for des flurane. To minimize the environmental impact of inhalation anesthesia: the choice of halogenated agent is fundamental (sevo flurane), nitrous oxide co-administration must be avoided, the fresh gas fl ow rate should be set to a minimum (manually or automatically), and the fraction of halogenated vapors delivered should be optimized. Given the current state of knowledge, sevo fl urane combined with a fresh gas fl ow of less than 1 L/min is the best carbon-saving option for inhaled general anesthesia.