Desflurane is a potent greenhouse gas.
Learn about
Hospitals that have removed desflurane from formulary
How your hospital can reduce desflurane and take the refuse-desflurane pledge
Alternatives to desflurane
These hospitals have Ditched the Des and removed it from their formulary
Will your hospital join them?
We already have good alternatives
Desflurane has no added benefit for patients and is harmful to the planet and our tax purse (see RCT, BJA editorial)
Desflurane’s GWP100 = 2540
One canister of desflurane (240ml) = 893kg CO2e
What we do today, matters in 100 years time.
The solution is us!
Refuse desflurane. Use propofol TIVA first line and sevoflurane second line.
Is it time that propofol TIVA become our default anaesthetic and sevoflurane second line?
Sevoflurane is good alternative to Desflurane. Propofol TIVA is an even better alternative. Currently Propofol TIVA is the “second-line” anaesthetic option for malignant hyperthermia, “tube-free” anaesthesia (e.g. rigid bronchoscopy), intra-operative monitoring of somatosensory or motor-evoked potentials, patients with high risk of PONV and patient transfer. Is it time Propofol becomes our default and Sevoflurane the second-line option for certain indications?
Proficiency in Propofol TIVA is an ANZCA requirement and is not a new or novel technique.
Propofol is good for patient, planet and purse.
*Propofol is toxic the aquatic environment and needs to be disposed of appropriately
These hospitals have taken the pledge to #DitchTheDes
Desflurane vapourisers removed from anaesthetic machines
Procurement is being reduced by at least 50% every year
Taking Desflurane off the formulary as soon as possible (2025 latest)
Is your hospital taking the pledge?
Help Australia & New Zealand to be desflurane free
Educate
1. Present harmful effects of desflurane at journal club.
Patient, planet, purse.
BJA Editorial to get you started.
2. Do monthly audits of desflurane use in department and feedback data
3. Distribute posters (you can use ours), use social media, email, hard copies
4. Distribute and use these handy Apps:
2. Refuse desflurane
Agree to be desflurane free by 2025*
Reduce current procurement by 50% every year
Prevent storage of desflurane vapourisers on anaesthetic machines (this avoids wastage when testing)
Remove desflurane from the formulary
*Why 2025? Many hospitals are near-ready to take desflurane off the formulary. The sooner the better. What we do today matters in 100 years time (Desflurane GWP100 = 2540). It doesn’t matter where you start. If we follow the principles of pharmacological elimination half-lives, a 95% reduction can be achieved when reducing procurement by 50% every year for 3 years. That means that hospitals should be ready to go desflurane-free by 2025…
3. Promote alternatives
Host propofol TIVA education sessions
Distribute the Association of Anaesthetist’s TIVA guidelines & present in your department
Do a quality improvement project involving propofol TIVA in your department (recipe here)
Ensure correct disposal of propofol (PS51 5.7.4)
Have your answers ready for the non-believer, educate yourself!
The Fifth National Audit Project (NAP5) found that cases of awareness during TIVA were mostly preventable and the most common contributory factor was lack of TIVA education and training
Use TRA2SH’s posters
Clicking on each poster will take you to the link of a journal which you can present in your department. You will have access to full articles via ANZCA library.
