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<p>Desflurane is a fluorinated ether anesthetic with several clinical benefits, including resistance to defluorination (reducing nephrotoxicity), rapid emergence, cardioprotective properties, and faster recovery of airway reflexes than other volatile agents. However, its use is increasingly restricted because of environmental concerns, and the European Union has finalized regulations to phase out its use from January 2026, citing its global warming potential. Although its 100-year global warming potential exceeds that of comparable agents, the most appropriate emission metric remains debated. Radiative forcing estimates indicate that current atmospheric concentrations of desflurane contribute approximately 0.00014 W/m<sup>2</sup>, compared with 2.33 W/m<sup>2</sup> for CO<sub>2</sub>, suggesting a minimal overall impact. Since sevoflurane yields lower values for all indicators, it should be prioritized when volatile anesthetics are used, whereas desflurane should be reserved for specific situations. Moreover, alternative anesthetics, including intravenous agents, have their own environmental burdens related to plastic waste, drug disposal, and energy consumption, indicating that restricting desflurane alone will not eliminate anesthetic-related environmental impacts. This review assesses the balance between desflurane’s clinical utility and environmental effects, identifies contexts in which it offers clinical advantages, summarizes its greenhouse gas contributions, and discusses mitigation strategies, including low-flow anesthesia, anesthetic gas capture and recycling. Judicious, environmentally conscious use of desflurane may allow it to remain an additional anesthetic option in selected clinical contexts, alongside other inhaled and intravenous anesthetics, while efforts to minimize its environmental footprint continue.</p> Graphical abstract <p></p>

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Environmental and clinical rationale for the use of desflurane: a review of the literature

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月4日

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  • Takahiro Tamura,
  • Takahiro Ando

摘要

Desflurane is a fluorinated ether anesthetic with several clinical benefits, including resistance to defluorination (reducing nephrotoxicity), rapid emergence, cardioprotective properties, and faster recovery of airway reflexes than other volatile agents. However, its use is increasingly restricted because of environmental concerns, and the European Union has finalized regulations to phase out its use from January 2026, citing its global warming potential. Although its 100-year global warming potential exceeds that of comparable agents, the most appropriate emission metric remains debated. Radiative forcing estimates indicate that current atmospheric concentrations of desflurane contribute approximately 0.00014 W/m2, compared with 2.33 W/m2 for CO2, suggesting a minimal overall impact. Since sevoflurane yields lower values for all indicators, it should be prioritized when volatile anesthetics are used, whereas desflurane should be reserved for specific situations. Moreover, alternative anesthetics, including intravenous agents, have their own environmental burdens related to plastic waste, drug disposal, and energy consumption, indicating that restricting desflurane alone will not eliminate anesthetic-related environmental impacts. This review assesses the balance between desflurane’s clinical utility and environmental effects, identifies contexts in which it offers clinical advantages, summarizes its greenhouse gas contributions, and discusses mitigation strategies, including low-flow anesthesia, anesthetic gas capture and recycling. Judicious, environmentally conscious use of desflurane may allow it to remain an additional anesthetic option in selected clinical contexts, alongside other inhaled and intravenous anesthetics, while efforts to minimize its environmental footprint continue.

Graphical abstract