Routine anesthesia choices can materially change surgery’s climate footprint
Hospitals may be able to reduce the climate impact of surgery while also lowering anesthetic spending by changing routine anesthesia practices, according to a study presented at the ANESTHESIOLOGY 2026 annual meeting.
The study examined a six-site academic health system that encouraged clinicians to use lower-emission approaches, reduce anesthetic waste and review individualized feedback on emissions. Researchers compared results from 2021 with outcomes after the changes began, covering January 2022 through October 2025.
Across 145,917 anesthetic episodes, estimated average emissions fell from 57.6 kilograms of carbon-dioxide equivalent per episode in 2021 to 31.6 kilograms afterward. That is a 45% reduction in the study’s estimate of emissions per anesthetic episode.
The findings are notable because operating rooms are among the most resource-intensive parts of a hospital. Anesthesia is only one component of that footprint, but it is one clinicians can influence during everyday care.
Targeting gases with an outsized warming effect
The intervention focused in part on inhaled anesthetic gases. The study description identifies desflurane and nitrous oxide as potent greenhouse gases, meaning their use can contribute substantially to the carbon footprint associated with an operation.
The health system encouraged greater use of sevoflurane and intravenous anesthesia, while reducing fresh-gas flow rates to limit waste. These were practical changes to anesthetic selection and delivery rather than a program centered on buying new equipment.
That distinction matters for hospital sustainability efforts. Large infrastructure projects can take years, require capital approval and compete with direct clinical investments. Practice changes can be introduced through clinical guidance, measurement and feedback, provided they remain compatible with patient care.
Researchers also supplied anesthesiologists with individualized emissions reports. The feedback was intended to help clinicians see how their decisions affected emissions and to support informed decision-making. In the study’s framing, the combination of lower-emission options, reduced waste and transparent reporting was central to the result.
Cost and quality remain part of the question
The candidate report says the program reduced anesthetic costs by nearly 40%, alongside the emissions reduction. It also says the changes were made without compromising patient safety or quality and that patient outcomes remained strong.
Those points are essential because a lower-emission clinical pathway is useful only if it remains appropriate for the patient and procedure. The report does not present a blanket instruction to replace one anesthetic technique in every case. Instead, it describes a health-system effort to make practical choices, reduce waste and give clinicians clearer information.
Lead author Etta Hanlon of Virginia Tech Carilion School of Medicine said the findings show hospitals can take meaningful steps to reduce surgery’s environmental impact without compromising safety or quality. Neil Macdonald of Carilion Clinic helped establish the clinician-feedback effort, including the individualized reports.
What the study does—and does not—establish
The results are based on a before-and-after comparison within one six-site academic health system. They show what occurred after the system implemented its changes; they do not by themselves prove that every hospital will achieve the same reduction or savings.
They also rely on estimated emissions expressed as carbon-dioxide equivalent, a standard measure used to compare climate impacts. Hospitals considering similar programs would need to examine their own case mix, available medications, clinical protocols and baseline use of anesthetic gases.
Still, the scale of the observed reduction makes the study a useful signal for health systems looking for operational climate measures that are close to clinical practice. Rather than treating the operating room’s environmental footprint solely as a facilities issue, the work places anesthetic choice, gas-flow management and clinician feedback within the conversation.
The study was presented at a scientific meeting, so further review and fuller reporting of methods and outcomes will be important. For now, its central finding is straightforward: at this health system, changing routine anesthesia practices was associated with substantially lower estimated emissions per anesthetic episode, lower anesthetic costs and maintained patient outcomes.
This article is based on reporting by Medical Xpress. Read the original article.
Originally published on medicalxpress.com
