Eco-friendly anesthesia practices halve surgical emissions and cut costs
A new study presented at ANESTHESIOLOGY 2026 found that hospitals can lower the environmental impact and expense of surgery by adjusting routine anesthesia practices. The approach involved using more sevoflurane and intravenous anesthesia, reducing fresh gas flow, and giving anesthesiologists feedback on their emissions. Across a six-site academic health system, these changes reduced emissions and costs without harming patient safety.
Operating rooms are resource-heavy parts of hospitals, and health care overall contributes significantly to greenhouse gases. Inhaled agents such as desflurane and nitrous oxide are especially potent climate-warming gases, making anesthetic choice a meaningful environmental lever. The six-site academic system tested practical changes: favoring sevoflurane and IV anesthesia, lowering fresh gas flow, and giving clinicians individualized emissions feedback.
Across 145,917 cases, average emissions per anesthetic fell from 57.6 to 31.6 kgCO2e. Desflurane use declined from 23.8% to 9.81%, while sevoflurane rose from 82.4% to 93.1%. Inhaled anesthetic spending dropped from $628,588 in 2021 to $379,010 in 2024. Safety measures showed no rise in recovery or hospital stays, reintubation, awareness, or postoperative nausea and vomiting.
If adopted more widely, these practices could lower hospitals' carbon footprints and anesthetic spending, potentially freeing resources for other care needs. Patients may benefit from maintained safety while receiving greener care. Anesthesiologists and health-system leaders would bear the main implementation burden, since change relies on clinician choices, waste reduction, and feedback rather than costly technology. The broader public could see reduced health-sector emissions, though actual climate and health effects would depend on scale, duration, and how many facilities adopt similar protocols.