Reduced Climate Impact Of Anaesthetic Gases

In brief:

• Greenhouse gas emissions from anaesthetic gases have decreased by 27% over the last ten years.
• If desflurane had been completely replaced by sevoflurane, the global climate impact of anaesthetic gases could have been reduced by a further 69%.[AT1]
• Worrying trend that the world's largest countries are increasing their use of desflurane.

Halogenated anaesthetic gases are a group of volatile anaesthetics used to induce and maintain unconsciousness during various medical procedures.

The results of the current study show that global greenhouse gas emissions from anaesthetic gases have decreased by 27% over the last decade to around two million tonnes of carbon dioxide equivalent.

The decrease is mainly due to high-income countries reducing the use of desflurane, the anaesthetic gas with the highest climate impact. The EU has decided to ban the gas from January 2026, but at the same time the use of desflurane has increased significantly in some countries. This now risks jeopardising progress, say the researchers.

"Desflurane is 2,500 times more potent than carbon dioxide. High-income countries, such as the United States, have sharply reduced their use but the gas still accounts for more than 60% of their climate emissions from anaesthetic gases. In some countries, such as Japan, China, India, Russia, Indonesia, Thailand, and Vietnam, we see an increase in desflurane use," says Adrien Talbot, doctoral student in anaesthesiology and intensive care at Lund University and senior consultant at Helsingborg Hospital.

He has been leading the research together with Peter Bentzer, senior lecturer in Anaesthesia and Intensive Care at Lund University and senior consultant at Skåne University Hospital in Malmö.

The study is based on global sales data of anaesthetic gases from 91 countries - covering 80% of the world's population. The researchers calculated the climate impact using global warming potentials, carbon dioxide equivalents, for a 100-year period and found that anaesthetic gases are a significant - but avoidable - source of greenhouse gas emissions in healthcare.

"We then examined the trends in usage of the most common anaesthetic gases between 2014 and 2023. The climate impact of desflurane in high-income countries halved over the ten-year period. However, in middle-income countries, emissions from the gas tripled even though the only benefit is a marginally shorter wake-up time, says Adrien Talbot.

A key to further reducing emissions is a broader transition to sevoflurane, an anaesthetic gas with a significantly lower climate impact and the same or even better clinical properties than other alternatives, say the researchers. If desflurane had been completely replaced by sevoflurane, the global climate impact of anaesthetic gases could have been reduced by a further 69%.

"While it is positive that several of the world's largest countries are able to offer anaesthesia and surgery to meet the healthcare needs of their populations, it is also worrying that they are often [AT3] choosing to use desflurane. If more people stopped using it, we could halve climate emissions and still double the number of anaesthetics in the world," says Peter Bentzer.

The researchers point out that increased use of anaesthetic gas is not necessarily a bad thing; it may, for example, mean that more women are put under general anaesthesia during difficult births or that more patients undergo surgery for cancer and fractures.

"The reason for our research team's engagement in studying the climate and environmental impact of healthcare is that we want an evidence-based change in healthcare, not the implementation of placard politics. This requires taking a holistic view and looking at the overall climate impact of potential changes in healthcare. We want to contribute knowledge so that we can reduce the risk of healthcare itself leading to a deterioration in people's health due to increased climate or environmental impact," says Peter Bentzer.