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. 2022 Dec 8;5(1):e40831. doi: 10.2196/40831

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©Priya Ramaswamy, Aalap Shah, Rishi Kothari, Nina Schloemerkemper, Emily Methangkool, Amalia Aleck, Anne Shapiro, Rakhi Dayal, Charlotte Young, Jon Spinner, Carly Deibler, Kaiyi Wang, David Robinowitz, Seema Gandhi. Originally published in JMIR Perioperative Medicine (http://periop.jmir.org), 08.12.2022.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Perioperative Medicine, is properly cited. The complete bibliographic information, a link to the original publication on http://periop.jmir.org, as well as this copyright and license information must be included.

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Mean mL per case of anesthetic agent per MAC-hour (the average minimum alveolar concentration [MAC] during a treatment period multiplied by the duration of treatment in hours) over time. The first mL per MAC-hour, or gas mileage, reduction occurred after the University of California San Francisco launched the fresh gas flow clinical decision support system with a rate threshold of 1 L per minute. In February 2021, the rate threshold was dropped to 0.7 L per minute and resulted in another drop in mL per MAC-hour of sevoflurane. BPA: Best Practice Advisory; sevo 0.7: sevoflurane 0.7 L per minute; sevo 1: sevoflurane 1 L per minute.