NACCS statement about the use of Desflurane

NACCS acknowledges the environmental impact of desflurane and supports its decommissioning from anaesthesia practice, except where there is perceived evidence of benefit in comparison with other available hypnotic agents. There is a belief amongst some Neuroanaesthetists that withdrawal of the drug from clinical practice would have a negative effect upon patient care, particularly for long intracranial  neurosurgical cases where it may  reduce the need for post operative ventilation and/or radiological investigation due to prolonged  emergence from anaesthesia.

Our current recommendation would therefore be that anaesthetists may continue to consider using Desflurane for intracranial surgery where the duration of anaesthesia is anticipated to be long (for example, greater than 10 hours) and the intention is to wake the patient at end of surgery.

We intend to audit ongoing use and will provide more details about this in due course.