Quantifying carbon dioxide emissions in paediatric anaesthesia practice: The impact of volatile anaesthetic choice: A...

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.

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.

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.

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.