TY - JOUR

T1 - The science behind banning desflurane

T2 - A narrative review

AU - Hendrickx, Jan F. A.

AU - Nielsen, Ole John

AU - De Hert, Stefan

AU - De Wolf, Andre M.

PY - 2022/10

Y1 - 2022/10

N2 - 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.

AB - 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.

KW - MORBIDLY OBESE-PATIENTS

KW - SEVOFLURANE

KW - RECOVERY

KW - ANESTHESIA

KW - ISOFLURANE

KW - CLIMATE

U2 - 10.1097/EJA.0000000000001739

DO - 10.1097/EJA.0000000000001739

M3 - Review

C2 - 36036420

VL - 39

SP - 818

EP - 824

JO - European Journal of Anaesthesiology, Supplement

JF - European Journal of Anaesthesiology, Supplement

SN - 0952-1941

IS - 10

ER -