The environmental footprint and ecotoxicity of sevoflurane and propofol anaesthesia: a retrospective observational modelling study
Authors' conclusion
TIVA with propofol generated less water contamination and avoided TFA release while producing locally biodegradable residues. Conversely, sevoflurane-derived TCIA and manual methods led to higher TFA emissions, contributing to its global irreversible accumulation.
Study context
- Population
- Adult GA procedures in three French university hospitals, each using one strategy3 hospitals
- Participants
- 10,717 / 7,207 / 15,461
- Exposure
- TIVA vs target-controlled inhalational anaesthesia (TCIA) vs Manual sevoflurane
- TIVAn = 10,717
- TCIAn = 7,207
- Manual sevofluranen = 15,461
- Outcome
- Estimated instantaneous and long-term water contamination potential of propofol and sevoflurane-derived TFA
Methodological detailsmulticentre
- Multicentre
Main finding
As reported in the abstract
Water contamination potential, 10-yr simulation (1000 h GA per year) · 10 yr
Trifluoroacetic acid (TFA) accumulated linearly in halogenated strategies (TCIA, manual sevoflurane)
29-35 million m3
Propofol contamination reached a steady plateau after ∼5 yr in the TIVA strategy, depending on waste management
2.6-2.9 million m3
Observational data: associations, not effects.
Original publication
The environmental footprint and ecotoxicity of sevoflurane and propofol anaesthesia: a retrospective observational modelling study. Br J Anaesth. Published 6 May 2026. doi:10.
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