Multi-centre clinical audit of oxygen and inhalant anaesthetic usage in equine anaesthesia: The potential benefits of training and low-flow techniques.
Authors: Louro Luís Filipe, Sinclair Charlotte, Hargreaves Laura, Coumbe Karen, Hajeeh Ali Mohamed, Percan Valentina, Bacon Becky, Kukaswadia Adam, Mair Tim
Journal: Equine veterinary journal
Summary
# Editorial Summary: Environmental Impact of Low-Flow Anaesthesia in Equine Practice Five equine hospitals participated in a multi-centre audit examining oxygen and isoflurane consumption during 414 general anaesthetics, with measurements taken before and after implementing a structured training programme in low-flow anaesthetic techniques. Between the two study periods (June–September 2022 and 2023), oxygen usage fell by 17.9% and isoflurane by 9.6%, translating to a 9.6% reduction in greenhouse gas emissions across the centres—from 14.6 to 13.2 tonnes CO₂ equivalent. Statistical modelling revealed that cases conducted in the second year produced approximately 10.4 kg CO₂ equivalents less per procedure, with each additional litre of oxygen consumed responsible for an increase of 0.12 kg CO₂e; anaesthesia duration and vapouriser settings also independently influenced emissions. These findings suggest that education in low-flow techniques represents a practical, achievable lever for reducing the substantial environmental footprint of equine anaesthesia without compromising clinical outcomes—a particularly relevant consideration given increasing pressure on veterinary practices to adopt sustainable protocols. Whilst further research across a broader range of hospitals would strengthen the evidence base, this audit provides compelling justification for integrating low-flow anaesthesia training into equine anaesthetic curricula and professional development programmes.
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Practical Takeaways
- •Training staff in low-flow anaesthesia techniques can meaningfully reduce both anaesthetic gas waste and environmental impact without compromising patient care
- •Optimising oxygen flow rates is a practical lever for reducing the carbon footprint of equine general anaesthesia procedures
- •Multi-centre adoption of sustainable anaesthesia practices could deliver substantial cumulative environmental and cost benefits across the equine veterinary sector
Key Findings
- •Implementation of low-flow anaesthesia training reduced isoflurane usage by 9.6% and oxygen usage by 17.9% between study periods
- •Greenhouse gas emissions decreased by 9.6% (from 14.6 to 13.2 tCO2e) following anaesthesia training programme
- •Cases in study period two (post-training) produced on average 10.4 kgCO2e less per case (p=0.01)
- •Each additional litre of oxygen consumed increased emissions by 0.12 kgCO2e, with oxygen usage identified as a significant predictor of GHG emissions