Evidence map›Paper›PMID 34724710›Full record

ArticleAnaesthesia2022

Principles of environmentally-sustainable anaesthesia: a global consensus statement from the World Federation of Societies of Anaesthesiologists.

S M White, C L Shelton, A W Gelb, C Lawson, F McGain, J Muret, J D Sherman, representing the World Federation of Societies of Anaesthesiologists Global Working Group on Environmental Sustainability in Anaesthesia

Abstract readConsensus Statement
PubMed Full text at PMC Publisher
In one paragraph

Article in Anaesthesia, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 77 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
77citing papers in PubMed, 6 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

77 citing papers in PubMed, 6 syntheses or guidelines pooled it.

  1. 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 · 2026
    Guideline
  2. Pooled it
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  7. Article
  8. Article
  9. Environmental impact of anesthetic gases.Medical gas research · 2026
    Review
  10. Intraoperative ventilation settings in Germany: an observational multicentre cross-sectional study.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2026
    Article
  11. Article
  12. Review
  13. Article
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17 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

S M WhiteDepartment of Anaesthesia, University Hospitals Sussex NHS Foundation Trust, Brighton, UK.
C L SheltonDepartment of Anaesthesia, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK.
A W GelbDepartment of Anesthesia and Peri-operative Care, University of California San Francisco, San Francisco, CA, USA.
C LawsonRoyal Victoria Infirmary, Newcastle upon Tyne, UK.
F McGainDepartments of Anaesthesia and Intensive Care, Western Health, Melbourne, Vic., Australia.
J MuretDepartments of Anaesthesia and Intensive Care, Institut Curie, PSL Research University, Paris, France.
J D ShermanYale School of Medicine and Associate Professor of Epidemiology in Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA.
representing the World Federation of Societies of Anaesthesiologists Global Working Group on Environmental Sustainability in Anaesthesia

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The Earth's mean surface temperature is already approximately 1.1°C higher than pre-industrial levels. Exceeding a mean 1.5°C rise by 2050 will make global adaptation to the consequences of climate change less possible. To protect public health, anaesthesia providers need to reduce the contribution their practice makes to global warming. We convened a Working Group of 45 anaesthesia providers with a recognised interest in sustainability, and used a three-stage modified Delphi consensus process to agree on principles of environmentally sustainable anaesthesia that are achievable worldwide. The Working Group agreed on the following three important underlying statements: patient safety should not be compromised by sustainable anaesthetic practices; high-, middle- and low-income countries should support each other appropriately in delivering sustainable healthcare (including anaesthesia); and healthcare systems should be mandated to reduce their contribution to global warming. We set out seven fundamental principles to guide anaesthesia providers in the move to environmentally sustainable practice, including: choice of medications and equipment; minimising waste and overuse of resources; and addressing environmental sustainability in anaesthetists' education, research, quality improvement and local healthcare leadership activities. These changes are achievable with minimal material resource and financial investment, and should undergo re-evaluation and updates as better evidence is published. This paper discusses each principle individually, and directs readers towards further important references.

Indexed as

Consensus Statements as TopicAnesthesiaAnesthesiologistsDelphi TechniqueEnvironmental ExposureGlobal HealthGlobal WarmingHumansScotlandSocieties, Medicalanaesthesiacarbonclimate changeconsensusenvironmentsustainability

Identifiers

PMID34724710
PMCPMC9298028

What OpenQuestion holds

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LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.