Inhaled anesthetics are potent greenhouse gases. Waste anesthetic gases (WAGs) are routinely vented off facility rooftops, where their emissions to the outdoor environment are currently not controlled. Several simple strategies can reduce these emissions, and serve to protect public health, without compromising patient care:
- Utilize low fresh gas flows
- Avoid high impact inhaled anesthetics: desflurane, nitrous oxide
- Consider intravenous and regional techniques
- Decommission/avoid installing nitrous oxide centralized piping, and substitute portable tanks that remain closed between use
- Consider investing in WAG trapping (for volatiles only) or WAG destroying (all inhaled anesthetics, including nitrous oxide) technology, only after all aforementioned interventions are maximized and institution cost/benefit analyses performed
Adapted from the ASA Anesthesiology Sustainability Checklist.