The science behind banning desflurane: A narrative review.

Eur J Anaesthesiol

From the Department of Anesthesiology, Onze-Lieve-Vrouw Hospital, Aalst (JFAH), Department of Basic and Applied Medical Sciences, Ghent University, Ghent (JFAH, SDH), Department of Anesthesiology, University Hospital and Department of Cardiovascular Sciences, Catholic University Leuven, Leuven, Belgium (JFAH), Department of Chemistry, University of Copenhagen, Copenhagen, Denmark (OJN), Department of Anesthesiology and Perioperative Medicine, Ghent University Hospital, Ghent, Belgium (SDH) and Department of Anesthesiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA (AMDW).

Published: October 2022

Potent inhaled anaesthetics are halogenated hydrocarbons with a large global warming effect. The use of fluorinated hydrocarbons (most are not anaesthetics) are being restricted but volatile anaesthetics have been exempted from legislation, until now: the EU has formulated a proposal to ban or at least severely restrict the use of desflurane starting January 2026. This narrative review addresses the implications of a politics-driven decision - without prior consultation with major stakeholders, such as the European Society of Anaesthesiology and Intensive Care (ESAIC) - on daily anaesthesia practice and reviews the potential scientific arguments that would support stopping the routine use of desflurane in anaesthetic practice. Of note, banning or severely restricting the use of one anaesthetic agent should not distract the user from sensible interventions like reducing fresh gas flows and developing technology to capture and recycle or destroy the wasted potent inhaled anaesthetics that we will continue to use. We call to join efforts to minimise our professional environmental footprint.

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Source
http://dx.doi.org/10.1097/EJA.0000000000001739DOI Listing

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