Nitrous Oxide Manifold and Other Reduction of Emissions (NoMoreGas): a multicentre observational study evaluating pre-utilisation loss of nitrous oxide
Authors' conclusion
Consistent with other reports, the data demonstrate a substantial discrepancy between the quantities of N2O procured and utilised clinically, indicative of significant pre-utilisation losses.
Study context
- Population
- Hospitals in a Greater London research network with at least one active nitrous oxide (N2O) manifoldhospitals, of 53
- Participants
- 18 hospitals
- Outcome
- 'N2O gap': discrepancy between clinically utilised N2O and the quantity procured by hospitals
Methodological detailsN2O utilisation data collected continuously over 5 days and extrapolated over a year; procurement records from the preceding financial year
- N2O utilisation data collected continuously over 5 days and extrapolated over a year; procurement records from the preceding financial year
Main finding
As reported in the abstract
N2O procured vs utilised
- Total N2O procured (L)
- 6 487 200
- N2O procured per site, median (IQR), L
- 304 200 (183 600-473 400)
- N2O utilised over 5-day collection per site, median (IQR), L
- 501 (42-1409)
- Extrapolated annual utilisation per site, median (IQR), L
- 36 573 (3066-102 857)
- Extrapolated total annual utilisation (L)
- 1 175 348
- Proportion of procured N2O utilised (estimated)
- 18%
- Pre-utilisation losses (L)
- 5 311 852
Observational data: associations, not effects.
Secondary outcomes
Anaesthetists' self-reported N2O use (survey) · previous year
- Used N2O within the previous year
- 70% (n=309)
- Used N2O once a week or more
- one-third (n=97)
Anaesthetists' opinions on manifold decommissioning
- Widespread support for decommissioning manifolds
Original publication
Nitrous Oxide Manifold and Other Reduction of Emissions (NoMoreGas): a multicentre observational study evaluating pre-utilisation loss of nitrous oxide. Br J Anaesth. Published 10 October 2024. doi:10.
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