Anesthetic Gases
Effective maintenance of anesthetic supplies and equipment can reduce wasteful usage, lowering greenhouse gas emissions and costs.
Strategies and Practices
- Conduct regular monitoring of airborne concentrations of waste gas
- Minimize fresh gas flow rates; switch to low flow or closed anesthesia systems
- Utilize efficient ventilation and scavenging systems
- Ensure anesthesia equipment is well-maintained without leaks
- Decommission or avoid construction of central nitrous oxide piping
- Portable E cylinders should be substituted in those locations where nitrous oxide use is considered essential
- Select anesthetic agents with lower GHG emissions (remove desflurane from formularies)
- Consider total intravenous anesthesia (TIVA) as an alternative to volatile/inhaled anesthetics
- Follow appropriate procedures for the disposal of IV anesthetics
- Switch to metered-dose inhaler alternatives (e.g., soft mist or dry powder)
Sources: Devlin-Hegedus, JA (2022), AHRQ Primer, National Academy of Medicine Climate Collaborative, Practice Greenhealth
