Effect of a Professional Information Campaign on the Use of Sevoflurane in Pediatric Anesthesia

Q: What was the goal of the professional information campaign?

To promote more rational use of sevoflurane in pediatric anesthesia by encouraging intravenous propofol for specific pediatric patient groups.

Q: How were outcomes assessed after the campaign?

A retrospective cohort compared pediatric anesthesia data from a pre-intervention period (Sep–Oct 2023) and a post-intervention period (Mar–Apr 2024), focusing on induction/maintenance agents and anesthesia-related complications.

Q: Did the campaign increase propofol use in pediatric anesthesia?

Yes. The rate of intravenous induction with propofol increased significantly from the pre-intervention period to the post-intervention period.

Sep 30, 2026

Uploaded by Grenda

Climate change driven by greenhouse-gas emissions is a major public health challenge, and healthcare contributes a substantial share, with operating rooms heavily affected by halogenated anesthetic gases. Sevoflurane is widely used in pediatric anesthesia despite high global warming potential. An informational campaign promoted rational sevoflurane use and recommended intravenous propofol for selected pediatric patient groups. A retrospective cohort compared two periods before and after the campaign, evaluating hypnotic agents and anesthesia-related complications with statistical testing.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages3

Reading Time8 min

AccessFree to download

Introduction

Study Design and Methods

Participants and Data Collection

Statistical Analysis

Results

Questionnaire and Awareness

Patient Characteristics

Changes in Propofol and Sevoflurane Use

Pediatric Anesthesia SCIENTIFIC LETTER OPEN ACCESS Effect of a Professional Information Campaign on the Use ofSevoflurane in Pediatric Anesthesia Lionel Bouvet1 | Aurélie Boutarin1 | Mathilde De Queiroz1 | Laurent Zieleskiewicz2 1Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Université Lyon 1, Lyon, France | 2Assistance Publique Des Hôpitaux de Marseille, Hôpital Nord, Aix Marseille University, Marseille, France Correspondence: Lionel Bouvet ([lionel.bouvet@chu-lyon.fr](lionel.bouvet@chu-lyon.fr)) Received: 22 April 2025 | Revised: 10 October 2025 | Accepted: 19 November 2025 Keywords: carbon footprint | global warming | halogenated anesthetic | pediatric anesthesia | sustainable anesthesia Climate change, due to the increase in greenhouse gas emissions linked to human activities, represents a major challenge for public health. Healthcare systems in developed countries contribute approximately 5%–10% of total carbon dioxide equivalent (CO2e) emissions [1] . Among these emissions, operating rooms are a major contributor mainly due to the use of halogenated anesthetic gases, such as sevoflurane. In fact, sevoflurane has a global warming potential over 100 years (GWP100) 130 times greater than carbon dioxide (CO2), though it is significantly less than desflurane [2] . Furthermore, halogenated anesthetics contribute to atmospheric pollution and introduce forever chemicals (PFAS) into aquatic ecosystems. Despite its environmental impact, sevoflurane is widely used in pediatric anesthesia because of its ease of administration, particularly when intravenous access is not available and in younger children. However, intravenous anesthetics such as propofol may be associated with fewer complications (e.g., laryngospasms, agitation, nausea, vomiting, and postoperative pain [3–5]) and have a considerably lower carbon footprint than halogenated anesthetics [2], although propofol presents some ecotoxic effects on aquatic life. We recently reported that an information campaign led by sustainable anesthesia groups at the Hospices Civils de Lyon resulted in a significant reduction in the carbon footprint related to halogenated anesthetics in adults, primarily due to a 90% reduction in desflurane use, which was replaced by sevoflurane, without a significant increase in propofol use [6] . To address the specificities of pediatric anesthesia, we conducted an informational campaign proposing new protocols to promote the rational use of sevoflurane in pediatric anesthesia. We then aimed to assess the impact of this information campaign on the use of propofol and sevoflurane at the pediatric operating theater of our institution. In November 2023, a questionnaire was distributed to anesthesiologists and nurse anesthetists working in the pediatric operating room of the Femme-Mère-Enfant Hospital, Lyon, France. This survey aimed to assess their knowledge of the ecological and medical issues related to the use of sevoflurane in pediatric anesthesia. Subsequently, an informational campaign was conducted in February 2024, consisting of three meetings with oral presentations and email dissemination of protocols suggesting the use of intravenous propofol rather than inhaled halogenated anesthesia for specific pediatric patient groups (Figure 1) . A retrospective cohort study was then performed to compare medical data from pediatric patients operated on during two periods: September–October 2023 (pre-intervention) and March–April 2024 (postintervention) . We analyzed the hypnotic agents used for anesthesia induction and maintenance, as well as the incidence of anesthesia-related complications. Data were expressed as medians (interquartile ranges) or numbers (percentages) . Statistical analyses were conducted using Chi-square and Mann–Whitney U tests, with a significance threshold of p < 0.05. Effect sizes were expressed as absolute differences in percentages or medians, with corresponding 95% confidence intervals. For continu

FAQs

What was the goal of the professional information campaign?

To promote more rational use of sevoflurane in pediatric anesthesia by encouraging intravenous propofol for specific pediatric patient groups.

How were outcomes assessed after the campaign?

A retrospective cohort compared pediatric anesthesia data from a pre-intervention period (Sep–Oct 2023) and a post-intervention period (Mar–Apr 2024), focusing on induction/maintenance agents and anesthesia-related complications.

Did the campaign increase propofol use in pediatric anesthesia?

Yes. The rate of intravenous induction with propofol increased significantly from the pre-intervention period to the post-intervention period.

Sep 30, 2026

Uploaded by Grenda