title: Closed circuit anesthesia: preservation of the environment.
abstract: Closed circuit anesthesia must be considered as a primary contributor enabling to reduce the damaging effect of anesthetic agents on the environment. Halogenated vapors and nitrous oxide damage both the macro-environment, i.e. the earth's atmosphere layer and the micro-environment, i.e. the operating room ambience. As nitrous oxide is one of the most toxic agents, and as pure oxygen is harmful to the lungs, a technique of closed circuit anesthesia has been developed which employs oxygen/air (0.35:0.35 l/min) as a carrier of isoflurane. The safety of this oxygen-air technique of closed circuit anesthesia has been demonstrated by the greater stability of oxygen concentrations in the circuit in comparison to the more extensively used oxygen-nitrous oxide technique.
authors.affiliation: Institute of Anaesthesiology and Intensive Care, University of Florence, Italy.
authors.forename: G P
authors.initials: GP
authors.lastname: Novelli
authors.forename: L
authors.initials: L
authors.lastname: Bonetti
mesh_terms: D000395:Air Pollutants, Occupational; D000764:Anesthesia, Closed-Circuit / Q000009:adverse effects*; D001272:Atmosphere; D004777:Environment; D006801:Humans; D007530:Isoflurane; D009609:Nitrous Oxide / Q000009:adverse effects; D010126:Ozone