ReviewBritish journal of anaesthesia2020
Environmental sustainability in anaesthesia and critical care.
Review in British journal of anaesthesia, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 150 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Accuracy of the MAAS Method (Minimal-flow Auto-control Anesthesia System) for the Administration of Desflurane and Sevoflurane in the Anesthetic Maintenance Phase. Prospective and Paired Observational Study.
Drug Wastage : Observational Study in the Operating Rooms of France
Who cites it
150 citing papers in PubMed, 6 syntheses or guidelines pooled it, 411 citations in OpenAlex.
- Environmental impact of laparoscopic and robotic colorectal surgery: a systematic review.Journal of robotic surgery · 2026Pooled it
- Increasing the environmental sustainability of operating rooms in Canada: an evidence-informed guideline for policy.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2026Guideline
- Effects of departmental green anaesthesia interventions on carbon dioxide equivalent emissions: a systematic review.British journal of anaesthesia · 2025Pooled it
- Safety and recovery profile of patients after inhalational anaesthesia versus target-controlled or manual total intravenous anaesthesia: a systematic review and meta-analysis of randomised controlled trials.British journal of anaesthesia · 2025Pooled it
- The carbon footprint of critical care: a systematic review.Intensive care medicine · 2024Pooled it
- Behavioural change interventions encouraging clinicians to reduce carbon emissions in clinical activity: a systematic review.BMC health services research · 2023Pooled it
- Comparison of Opioid-Free Versions of Total Intravenous Anesthesia and Inhalational Anesthesia in Bariatric Surgery: A Randomized Controlled Trial.Obesity surgery · 2026Trial
- Laparoscopic versus robot-assisted left hemicolectomy: A pilot study on sustainability.Techniques in coloproctology · 2025Trial
- Trial
- Association between the EU desflurane phase-out and secondary market vaporizer prices: An observational time-series analysis.Journal of anesthesia and translational medicine · 2026Article
- Awake laparoscopic surgery under combined spinal-epidural anesthesia: a consecutive series of 52 patients across multiple general surgical procedures.Surgical endoscopy · 2026Article
- Beyond Disposability: A Systematic Review of Reusable and Single-Use Products in Hygiene-Related Nursing Care in the ICU.Nursing reports (Pavia, Italy) · 2026Review
- From carbon cost to climate care: Greening our intensive care units.World journal of critical care medicine · 2026Review
- Anaesthesia Waste Gases and Bioethics: Balancing Patient Care, Environmental Responsibility, and Occupational Safety.Developing world bioethics · 2026Review
- Carbon footprint associated with neonatal intensive care unit admission of very preterm infants: A retrospective pilot study applying life cycle assessment.European journal of pediatrics · 2026Observational
- Sustainable Healthcare: A Perspective on the Current Landscape, Frameworks, Barriers, and Implementation Model in a Quaternary Hospital System.International journal of environmental research and public health · 2026Review
- Quantifying carbon dioxide emissions in paediatric anaesthesia practice: The impact of volatile anaesthetic choice: A prospective, randomised, single-blinded comparative study.Indian journal of anaesthesia · 2026Article
- Beyond the numbers: Contextualising the carbon footprint of Desflurane versus Sevoflurane in India.Indian journal of anaesthesia · 2026Article
- The 0.00015 degree problem: learning from the environmental debates around desflurane.Anaesthesia · 2026Article
- Implementing a Green ICU Pathway Across a Large U.S. Health System: An Observational Study.Critical care explorations · 2026Observational
90 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
4 authors at 4 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The detrimental health effects of climate change continue to increase. Although health systems respond to this disease burden, healthcare itself pollutes the atmosphere, land, and waterways. We surveyed the 'state of the art' environmental sustainability research in anaesthesia and critical care, addressing why it matters, what is known, and ideas for future work. Focus is placed upon the atmospheric chemistry of the anaesthetic gases, recent work clarifying their relative global warming potentials, and progress in waste anaesthetic gas treatment. Life cycle assessment (LCA; i.e. 'cradle to grave' analysis) is introduced as the definitive method used to compare and contrast ecological footprints of products, processes, and systems. The number of LCAs within medicine has gone from rare to an established body of knowledge in the past decade that can inform doctors of the relative ecological merits of different techniques. LCAs with practical outcomes are explored, such as the carbon footprint of reusable vs single-use anaesthetic devices (e.g. drug trays, laryngoscope blades, and handles), and the carbon footprint of treating an ICU patient with septic shock. Avoid, reduce, reuse, recycle, and reprocess are then explored. Moving beyond routine clinical care, the vital influences that the source of energy (renewables vs fossil fuels) and energy efficiency have in healthcare's ecological footprint are highlighted. Discussion of the integral roles of research translation, education, and advocacy in driving the perioperative and critical care environmental sustainability agenda completes this review.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.