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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. |
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