{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T23:48:55Z","timestamp":1787269735284,"version":"build-2736575974"},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims:<\/jats:title>\n                    <jats:p>\n                      Carbon foot printing provides a metric for the environmental burden\u2014energy, waste, and potent greenhouse emissions\u2014inherent in our daily clinical practice. This study quantifies and compares the carbon dioxide (CO\n                      <jats:sub>2<\/jats:sub>\n                      )-equivalent emissions of sevoflurane versus desflurane in paediatric patients using the validated Dr. Tom Pierce anaesthetic gas calculator.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      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                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 25) or Group D (Desflurane,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 25). Environmental impact was calculated based on real-time consumption data using Dr Tom Pierce\u2019s anaesthetic gases calculator application.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      While haemodynamic stability and bispectal index\u2013monitored depth remained consistent across both cohorts, the ecological divergence was profound. The mean agent consumption was significantly lower in the S group (28.39 \u00b1 15.88) as compared to the D group (49.30 \u00b1 0.29). Most strikingly, the mean CO\n                      <jats:sub>2<\/jats:sub>\n                      emission for sevoflurane (3.68 \u00b1 2.02) was a mere fraction of the impact seen with desflurane (100.55 \u00b1 74.68), representing a massive reduction in the global warming potential per case.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>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 \u201cgreen anaesthesia\u201d protocols, though further multicentre validation is required to solidify these environmental benchmarks.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ija.ija_1690_25","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T12:00:46Z","timestamp":1787227246000},"page":"943-950","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Quantifying carbon dioxide emissions in paediatric anaesthesia practice: The impact of volatile anaesthetic choice: A prospective, randomised, single-blinded comparative study"],"prefix":"10.4103","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-1804-5972","authenticated-orcid":false,"given":"Saumya","family":"Pant","sequence":"first","affiliation":[{"name":"Department of Anaesthesia and Pain Management, Himalayan Institute of Medical Sciences, SRHU, Dehradun, Uttarakhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5599-5514","authenticated-orcid":false,"given":"Parul","family":"Jindal","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Pain Management, Himalayan Institute of Medical Sciences, SRHU, Dehradun, Uttarakhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5652-5031","authenticated-orcid":false,"given":"Amit K.","family":"Chauhan","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Pain Management, Himalayan Institute of Medical Sciences, SRHU, Dehradun, Uttarakhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,8,20]]},"reference":[{"key":"R2-20260820","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1016\/j.bja.2022.04.022","article-title":"Carbon footprint of inhalational and total intravenous anaesthesia for paediatric anaesthesia: A modelling study","volume":"129","author":"Narayanan","year":"2022","journal-title":"Br J Anaesth"},{"key":"R3-20260820","doi-asserted-by":"crossref","first-page":"104882","DOI":"10.1016\/j.resconrec.2020.104882","article-title":"The green print: advancement of environmental sustainability in healthcare","volume":"161","author":"Sherman","year":"2020","journal-title":"Resour Conserv Recycl"},{"key":"R4-20260820","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1111\/anae.15785","article-title":"Action guidance for addressing pollution from inhalational anaesthetics","volume":"77","author":"Devlin\u2010Hegedus","year":"2022","journal-title":"Anaesthesia"},{"key":"R5-20260820","doi-asserted-by":"crossref","first-page":"18","DOI":"10.33545\/26643766.2024.v7.i2a.467","article-title":"Moving towards green anaesthesia: Strategies for reducing environmental impact","volume":"7","author":"Srinivasareddy","year":"2024","journal-title":"Int J Med Anaesthesiol"},{"key":"R6-20260820","first-page":"4561","article-title":"Comparison of desflurane and sevoflurane on postoperative recovery quality after tonsillectomy and adenoidectomy in children","volume":"17","author":"Wu","year":"2019","journal-title":"Exp Ther Med"},{"key":"R7-20260820","doi-asserted-by":"crossref","first-page":"41","DOI":"10.22514\/sv.2026.013","article-title":"Inhalational vs. Intravenous anesthesia: Is opposition helpful for clinicians?","volume":"22","author":"Adembri","year":"2026","journal-title":"Signa Vitae"},{"key":"R8-20260820","article-title":"Environmental and clinical rationale for the use of desflurane: A review of the literature","author":"Tamura","year":"2026","journal-title":"J Anesth"},{"key":"R9-20260820","doi-asserted-by":"crossref","first-page":"e4","DOI":"10.1016\/j.bja.2019.09.036","article-title":"Age-dependent decrease in minimum alveolar concentration of inhaled anaesthetics: A systematic search of published studies and meta-regression analysis","volume":"124","author":"Cooter","year":"2020","journal-title":"Br J Anaesth"},{"key":"R10-20260820","doi-asserted-by":"crossref","first-page":"680","DOI":"10.1016\/j.bja.2020.06.055","article-title":"Environmental sustainability in anaesthesia and critical care","volume":"125","author":"McGain","year":"2020","journal-title":"Br J Anaesth"},{"key":"R12-20260820","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/1471-2253-8-4","article-title":"Desflurane consumption during automated closed-circuit delivery is higher than when a conventional anaesthesia machine is used with a simple vaporizer-O\u2082-N\u2082O fresh gas flow sequence","volume":"8","author":"De Cooman","year":"2008","journal-title":"BMC Anesthesiol"},{"key":"R13-20260820","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1097\/00000539-200003000-00032","article-title":"The effects of sevoflurane on serum creatinine and blood urea nitrogen concentrations: A retrospective, twenty-two-centre, comparative evaluation of renal function in adult surgical patients","volume":"90","author":"Mazze","year":"2000","journal-title":"Anesth Analg"},{"key":"R14-20260820","doi-asserted-by":"crossref","first-page":"1086","DOI":"10.1213\/ANE.0b013e31824f6940","article-title":"Life cycle greenhouse gas emissions of anaesthetic drugs","volume":"114","author":"Sherman","year":"2012","journal-title":"Anesth Analg"},{"key":"R15-20260820","doi-asserted-by":"crossref","first-page":"1480","DOI":"10.1111\/anae.14835","article-title":"Calculating the carbon dioxide equivalent produced by vaporising a bottle of desflurane \u2013 A reply","volume":"74","author":"Pierce","year":"2019","journal-title":"Anaesthesia"}],"container-title":["Indian Journal of Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ija.ija_1690_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T12:00:48Z","timestamp":1787227248000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ija.ija_1690_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":13,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/ija.ija_1690_25","relation":{},"ISSN":["0019-5049","0976-2817"],"issn-type":[{"value":"0019-5049","type":"print"},{"value":"0976-2817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8]]},"assertion":[{"value":"2025-12-20","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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