A survey of the choice of general anaesthetic agents in Australia and New Zealand

Strategies to reduce the adverse environmental costs of anaesthesia include choice of agent and fresh gas flows. The current preferences of Australian and New Zealand anaesthetists are unknown. We conducted a survey of Australian and New Zealand anaesthetists to determine the use of volatiles, nitro...

Full description

Saved in:
Bibliographic Details
Published in:Anaesthesia and intensive care 2019-05, Vol.47 (3), p.235-241
Main Authors: McGain, Forbes, Bishop, Jason R, Elliot-Jones, Laura M, Story, David A, Imberger, Georgina LL
Format: Article
Language:English
Subjects:
Age
Anesthesia
Anesthesiology
Anesthetics
Australian and New Zealand College of Anaesthetists (ANZCA)
Automation
Climate change
Consumption
Emission standards
Emissions
Gas flow
Gases
Gender
Intensive care
Medical care, Cost of
Nitrous oxide
Physiological effect
Polls & surveys
Response rates
Therapeutic use
Workforce
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Strategies to reduce the adverse environmental costs of anaesthesia include choice of agent and fresh gas flows. The current preferences of Australian and New Zealand anaesthetists are unknown. We conducted a survey of Australian and New Zealand anaesthetists to determine the use of volatiles, nitrous oxide and intravenous anaesthesia, lowest fresh gas flow rates, automated end-tidal volatile control, and the rationales for these choices. The survey was answered by 359/1000 (36%), although not all questions and multiple responses within single questions were answered by all respondents. Sevoflurane was preferred by 246/342 (72%, 95% confidence interval (CI) 67%-77%), followed by propofol, 54/340 (16%, 95% CI 12%-20%), desflurane 39/339 (12%, 95% CI 8%-16%) and isoflurane 3/338(1%, 95% CI 0-3%). When asked about all anaesthetics, low-risk clinical profile was the most common reason given for using sevoflurane (129/301 (43%, 95% CI 37%-49%)), reduced postoperative nausea for propofol (297/318 (93%, 95% CI 90%-96%)) and faster induction/awakening times for desflurane (46/313 (79%, 95% CI 74%-83%)). Two-thirds (226/340 (66%, 95% CI 61%-71%)) of respondents used nitrous oxide in 0-20% of general anaesthetics. Low fresh gas flow rates for sevoflurane were used by 310/333 (93%, 95% CI 90%-95%) and for 262/268 (98%, 95% CI 95%-99%) for desflurane. Automated end-tidal control was used by 196/333 (59%, 95% CI 53%-64%). The majority of respondents (>70%) preferred sevoflurane at low flows. These data allow anaesthetists to consider further whether changes are required to the choices of anaesthetic agents for environmental, financial, or any other reasons.
ISSN:0310-057X
1448-0271
DOI:10.1177/0310057X19836104