Optimal Fresh Gas Flow when Employing Total Intravenous Anesthesia
Authors' conclusion
The optimal FGF is context specific. It is highly dependent on a country's grid emissions factor and the method of carbon dioxide absorbent disposal.
Study context
- Population
- Total intravenous anesthesia (TIVA) cases in an institution in Singapore; global grid emissions factor settings
- Comparison
- Fresh gas flow 1 to 10 l/min during TIVA
- Outcome
- Annual cost and GWP 100 (oxygen, air, CO2 absorbent production and disposal) across FGFs
Methodological detailsweb-based calculator, single-institution application (Singapore), Component costs from institutional data, fresh gas flow (FGFs) 1 to 10 l/min and F io2 30 to −60% modeled
- Web-based calculator
- Single-institution application (Singapore)
- Component costs from institutional data
- FGFs 1 to 10 l/min and F io2 30 to −60% modeled
Main finding
As reported in the abstract
Annual cost and GWP 100 in the study's institution (grid emissions factor 0.599 kgCO 2 e/kWh; 36.4% TIVA; F io2 30%)
Annual cost at 1 l/min
S$) 12,948
Annual cost at 10 l/min
S$1,572
Annual GWP 100 at 1 l/min (increased nearly linearly with FGF)
1,939 kgCO 2 e
Annual GWP 100 at 10 l/min
5,910 kgCO 2 e
Further findings
FGF minimising GWP 100 globally by grid emissions factor (landfill disposal assumed)
- Higher FGF decreased GWP 100 at grid emissions factor ≤0.011 kgCO 2 e/kWh
- Favorable up to 6 l/min at grid emissions factor 0.011 to 0.080
- Favorable up to 4 l/min at grid emissions factor 0.080 to 0.20
- Higher FGF increased GWP100 at grid emissions factor ≥0.200
- Assuming landfill disposal
Original publication
Optimal Fresh Gas Flow when Employing Total Intravenous Anesthesia. Anesthesiology. Published 9 March 2026. doi:10.
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