Inhalational Anaesthesia Cost Simulator - IACS-v2

License: GNU GPL v3. Copyright (C) 2026 Prof. Jyotirmay Kirtania

SEVOFLURANE
Agent — ISO vaporiser colour code
Gas circuit
N₂O — Blue cylinder (India)  ■   D-type · 30 kg · 16 395 L at 20 °C · ₹6 000 refill · ₹0.3660/L · ₹200/kg
Fresh gas flows (L/min)
Enable N₂O+O₂ circuit above
Inspired O₂ fraction — FiO₂ (from FGF composition)
%
02125304060100%
✓ FiO₂ safe
O₂: —  Air: —  N₂O: —
FGF within recommended range
Vaporizer & timing
Max 8% (Sevoflurane vaporizer)
1.000 = sea level · Varanasi ≈ 1.000
Volatile agent price — India 2026
Inst: Sevorane/Kelsevo tender rate
D-cyl 30 kg refill ≈ ₹6 000 → ₹200/kg
Agent Institutional ₹/250mL Retail MRP ₹/250mL Common brands
Sevoflurane ₹ 3,500 ₹ 8,500 Sevorane (Abbott), Kelsevo (Celon), Sevitrue
Isoflurane ₹ 500 ₹ 1,200 Forane (Abbott), Aerrane (Baxter), Isifrane, Piramal
Desflurane ₹ 5,000 ₹ 9,500 Suprane 240 mL (Baxter) — only brand in India
Halothane ₹ 400 ₹ 700 Fluothane (Piramal) — limited availability
Prices as of 2026 · Institutional = tender/contract rate · Retail = open market/chemist MRP · Desflurane pack is 240 mL (Suprane); price shown normalized to 250 mL equivalent
Sodalime — amortized separately (India: 5 L can standard)
Drägersorb 800+ 5 L · ₹1850–2250
Standard India hospital pack = 5 L
Adult ~200 · Paediatric ~100–150
Product Pack ₹ Institutional CO₂ cap (L/L) Indicator
Drägersorb 800+ 5 L ₹ 2,000 221 White → Violet-blue
Intersorb Plus 5 L ₹ 1,800 265 Pink → White (exhausted)
Drägersorb CLIC 1.2 L ₹ 550 221 White → Violet (single use)
CO₂ capacity: Drägersorb 260 mL/g × 850 g/L bulk density = 221 L CO₂/L · Intersorb 265 mL/g × 1000 g/L = 265 L CO₂/L · Source: manufacturer data; Moody et al. Med Gas Res 2020

Sevoflurane — per-minute consumption & cost
Vapor output
mL vapor / min
Liquid consumed
mL liquid / min
Mass consumed
mg / min
Agent cost
₹ / min
N₂O cost
₹ / min
Sodalime cost
₹ / min
Total cost / minute
agent + N₂O + sodalime (workstation & CMC excluded)
Cost / MAC-hour
volatile agent only
MAC fraction delivered  
— MAC
Cumulative costs — 60 minutes
Volatile liquid consumed
Fraction of 250 mL bottle
N₂O consumed
Sodalime consumed
Agent cost
N₂O cost
Sodalime cost
Total anaesthetic gas cost
🌿 Environmental impact — Global Warming Potential (GWP₁₀₀)
Low impact
Agent CO₂-eq / min
g CO₂-eq / min
N₂O CO₂-eq / min
g CO₂-eq / min (GWP 273)
Total CO₂-eq / min
g CO₂-eq / min
Session total CO₂-eq
kg CO₂-eq for 60 min
Agent GWP₁₀₀
× CO₂ over 100 yr
Equivalent driving
km (120 g CO₂/km avg car)
GWP relative to agents (Sevo=1)
GWP₁₀₀ source: Sulbaek Andersen MG et al. J Phys Chem A 2010 · N₂O: IPCC AR6 2021 (GWP=273) · Sevo 130 · Iso 510 · Des 2540 · Halo ~40 · Sherman J et al. Anesth Analg 2012;114:1086 · McGain F et al. Anaesth Intens Care 2021
Agent physical properties & MAC — reference

† mL vapour per mL liquid at 20 °C, 1 atm — derived: (ρ/MW) × 24 040 mL/mol.  MAC: Eger EI, Am J Health Syst Pharm 2004;61(S4):S3–10.  N₂O: 1 kg = 546.5 L at 20 °C.  Colour codes: ISO vaporiser convention (Dräger / GE / Penlon).

Core formula — ideal gas law at 20 °C, 1 atm (molar volume 24.04 L/mol):
V_vapor (mL/min) = FGF_total (mL/min) × dial% / 100
n (mol/min)  = V_vapor / 24 040
m (g/min)    = n × MWagent
V_liq (mL/min) = m / ρagent

N₂O: 1 kg → (1 000/44.01) mol × 24.04 L/mol = 546.5 L at 20 °C
Sodalime (g/min) = CO₂_production (mL/min) ÷ capacity (mL CO₂/g)
References:

1. Biro P. Calculation of volatile anaesthetics consumption from agent concentration and FGF. Acta Anaesthesiol Scand 2014;58(8):968–72. PMID 25060161

2. Moody AE et al. Predicting cost of inhalational anaesthesia at low FGF. Med Gas Res 2020;10(2):64–66. PMC7885709

3. Pierce JMT et al. Validation of anaesthetic impact calculator mathematics. Anaesthesia 2020;75(1):112–15. doi:10.1111/anae.14896

4. Eger EI. Characteristics of anaesthetic agents. Am J Health Syst Pharm 2004;61(S4):S3–10.

5. Weinberg L et al. Pharmacoeconomics of volatile agents. Anaesth Intensive Care 2010;38(5). DOI

6. Boldt J et al. Economic considerations: propofol vs volatiles. Anesth Analg 1998;86:504–9. PMID 9495402

7. Odin I, Feiss P. Low flow and economics. Best Pract Res Clin Anaesthesiol 2005;19:399–413.

8. Tollinche L et al. Volatile consumption audit by FGF. Int J Anesthetic Anesthesiol 2018;5:064. Open access

⚠ Workstation purchase price and annual 5% CMC are excluded from amortized cost. Sodalime is an amortized line item separate from agent cost. Cost/MAC-hour is for volatile agent only. Medical oxygen constitutes an essential infrastructure requirement for critical care and anesthesia; consequently, its separate billing is considered unfair business practice under current Indian regulatory guidelines. Disclaimer: This software is intended to be used only for medical education and training. It is not a regulator approved anaesthesia billing software.