The environmental effects of anesthetic agents and anesthesia practices.

Abstract

Anesthesia is a critical domain with considerable capacity to reduce the carbon footprint of healthcare on the environment, particularly in terms of climate change. Volatile anesthetics are halogenated gases that function as potent greenhouse gases and contribute to the greenhouse effect, depletion of the ozone layer, and progression of global warming. However, the use of volatile anesthetics can be decreased significantly through the adoption of more environmentally conscious practices. Regional anesthesia, including intravenous and neuraxial anesthesia, reduces the harmful effects of inhaled anesthetics and has shown to have positive perioperative effects in certain patient populations. Combining total intravenous anesthesia with target-controlled infusion results in optimized infusion rates, thereby reducing both anesthetic use and waste. Techniques such as processed electroencephalogram monitoring can be used to assess the sedation of a patient and prevent over-anesthetizing and consequently decreasing anesthetic use, which may contribute to improved surgical outcomes. Additionally, actively promoting education on low-flow administration practices can enhance the recycling of anesthetic gases and decrease the release of volatile anesthetics into the atmosphere, thereby reducing the carbon footprint of this field. Finally, by refining existing techniques and scavenging systems, xenon, with its physiological stability and minimal environmental impact, could emerge as a leading inhaled anesthetic agent in the future.