Environmental Sustainability in Anesthesia Practice: Strategies to Reduce Carbon Emissions and Waste

Background: The healthcare sector is a significant contributor to environmental degradation, accounting for a substantial portion of national greenhouse gas emissions. Within hospitals, operating rooms (ORs) and anesthesia practice are identified as major sources of carbon emissions and waste due to energy-intensive ventilation, single-use consumables, and the use of potent inhaled anesthetic agents. Aim: This article aims to outline pragmatic, high-yield strategies for anesthesiologists to reduce the environmental footprint of perioperative care, thereby aligning clinical practice with planetary health. Methods: The proposed strategies are grounded in life-cycle assessment (LCA) methodology, which evaluates the environmental impact of products and processes from manufacture to disposal. The recommendations are structured around the "Reduce, Reuse, Recycle" hierarchy. Key methods include reducing the use of high-global warming potential anesthetic agents like desflurane and nitrous oxide, adopting low fresh gas flows, and transitioning to total intravenous or regional anesthesia where clinically appropriate. Reuse strategies focus on implementing reusable medical devices (e.g., laryngeal mask airways, textiles) where validated by LCA and infection control standards. Recycling initiatives emphasize proper waste segregation to divert uncontaminated materials from costly, polluting incineration. Results: Evidence indicates that these strategies can dramatically reduce the carbon footprint of anesthesia. For instance, substituting sevoflurane for desflurane and optimizing gas flows has led to emission reductions equivalent to taking thousands of cars off the road. Furthermore, proper waste segregation can cut disposal costs by up to 80%.Conclusion: Anesthesiologists are uniquely positioned to lead healthcare's response to the climate crisis. By adopting evidence-based, sustainable practices, the specialty can significantly mitigate its environmental impact without compromising patient safety, turning a critical challenge into an opportunity for professional leadership.