Greener anesthesia cuts operating room emissions in half, slashes anesthetic costs nearly 40%
Hospitals can sharply reduce the climate impact and cost of surgery without compromising patient safety by changing routine anesthesia practices, including reducing the use of high-emission anesthetic gases, suggests a new study presented at the ANESTHESIOLOGY 2026 annual meeting.
A new study presented at ANESTHESIOLOGY 2026 reveals that hospitals can significantly lower the carbon footprint and expenses of surgery without sacrificing patient safety by altering routine anesthesia practices. Operating rooms constitute a major portion of hospital resource utilization, and certain inhaled anesthetic gases, especially desflurane and nitrous oxide, are potent greenhouse gases contributing to climate change.
The research, led by Etta Hanlon at Virginia Tech Carilion School of Medicine, indicates that hospitals can achieve substantial environmental benefits by switching to less harmful anesthetic agents, reducing waste, and providing anesthesiologists with clear feedback. Implementing these changes in six academic health systems resulted in a 45% reduction in total emissions per anesthetic episode, dropping from 57.6 kilograms of carbon dioxide equivalent (kgCO2e) in 2021 to 31.6 kg in 2025.
Desflurane usage plummeted from 23.8% to 9.81%, while sevoflurane use rose from 82.4% to 93.1%. By late 2025, the health system had already achieved a 50% reduction in emissions. Anesthetic costs plunged nearly 40%, from $628,588 in 2021 to $379,010 in 2024. Patient outcomes remained stable, with no increase in recovery room stays, hospital stays, breathing tube reinsertion, awareness, or postoperative nausea and vomiting.
Sara Wohlford, director of sustainability at Carilion Clinic, emphasizes that patients do not need to compromise between environmentally responsible healthcare and high-quality care. The study involved 145,917 anesthetic episodes and demonstrated that lower-emission agents, reduced fresh gas flow, and clinician feedback led to a 45% decrease in emissions per episode without impacting patient safety or postoperative complications.
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