Environmental impact of anaesthesia
Inhaled anaesthetic gases are vented largely unchanged into the atmosphere. Their contribution to climate change depends on global warming potential (GWP), atmospheric lifetime, and how much agent is used (fresh gas flow, MAC, duration).
Key takeaways
- Desflurane is among the highest-impact volatile agents and is being reduced or removed in many systems.
- Nitrous oxide has a long atmospheric lifetime and can be a major contributor when used.
- Lower fresh gas flows and avoiding high-GWP agents can reduce emissions substantially.
GWP (100-year) comparisons (illustrative)
| Agent | Approx. atmospheric lifetime | GWP100 (CO₂=1) | Notes |
|---|---|---|---|
| Desflurane | ~14 years | ~2,540 | High MAC and high GWP; major footprint driver |
| Sevoflurane | ~1.1 years | ~130 | Lower GWP than desflurane |
| Isoflurane | ~3.2 years | ~510 | Intermediate |
| Nitrous oxide | ~114 years | ~298 | Long-lived; can dominate footprint when used |
| Propofol (TIVA) | Not an atmospheric gas | N/A | Life-cycle assessments compare manufacturing/waste rather than atmospheric venting |
“Per hour” impact depends on technique
The same agent can have very different footprints depending on fresh gas flow and duration. Life-cycle and clinical modeling show large differences between desflurane, sevoflurane, and nitrous oxide under comparable conditions.
Practical emission-reduction strategies
- Avoid desflurane when alternatives are clinically appropriate
- Minimize or avoid nitrous oxide where possible
- Use low-flow anaesthesia when clinically appropriate and equipment supports it
- Consider TIVA in selected cases (weighing clinical pros/cons)
- Use scavenging and system maintenance to reduce leaks