Position Statement of the Neuro Anaesthesia Society on the Use of Desflurane

The Neuro Anaesthesia Society supports the responsible, evidence-based use of inhalational anaesthetic agents in a manner that prioritises patient safety while recognising the importance of environmental sustainability.

The Society believes that:

1. Global Warming Potential (GWP) alone is not an appropriate metric by which to judge the environmental impact of desflurane.
2. The choice of anaesthetic agent should remain a clinical decision made by the responsible anaesthetist in the best interests of the individual patient. There are circumstances in which desflurane may offer clinical advantages, and clinicians should retain the professional autonomy to select the agent they consider most appropriate after weighing the risks and benefits for each patient.
3. The routine use of desflurane should not be encouraged when alternative anaesthetic techniques or agents can provide equivalent clinical outcomes. Where suitable alternatives exist that achieve the same standard of patient care with a lower environmental impact, these should generally be preferred.

The Neuro Anaesthesia Society supports continued research into the environmental effects of anaesthetic practice and encourages measures that reduce emissions without compromising patient care. Environmental stewardship and excellence in clinical practice should be viewed as complementary objectives, with patient welfare remaining the overriding priority in all anaesthetic decision-making.

Articles:

1. Inhalational Volatile Anaesthetic Agents: The Atmospheric Scientists’ Viewpoint
2. The Science of Climate Change and the Effect of Anaesthetic Gas Emissions
3. Climate Change, Emissions of Volatile Anesthetics, and Policy Making: The Case of Desflurane