ArticleBritish journal of anaesthesia2025
A nationwide approach to reduction in anaesthetic gas use: the Dutch Approach to decarbonising anaesthesia.
Article in British journal of anaesthesia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- Intraoperative ventilation settings in Germany: an observational multicentre cross-sectional study.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2026Observational
- Environmental Impact of a Vaginal Pelvic Organ Prolapse Procedure: A Life Cycle Assessment with Scenario Modelling of Mitigation Strategies.International urogynecology journal · 2026Article
- Beyond the numbers: Contextualising the carbon footprint of Desflurane versus Sevoflurane in India.Indian journal of anaesthesia · 2026Article
- Environmental and clinical rationale for the use of desflurane: a review of the literature.Journal of anesthesia · 2026Review
- Implementation of a low-flow intervention at a veterinary teaching hospital: an environmental initiative.Scientific reports · 2026Article
- Barriers and enablers to sustainable anaesthetic practice: a mixed-methods study.British journal of anaesthesia · 2026Article
- Green transplant: A scoping review of sustainability challenges and opportunities in transplantation.World journal of transplantation · 2026Review
- Protecting clinician autonomy and patient safety within the climate debate: the case for desflurane in modern anaesthesia.Current opinion in anaesthesiology · 2026Review
- Article
- A nationwide approach to reduction in anaesthetic gas use: the Dutch approach delivers measurable emissions cuts. Response to Br J Anaesth 2025: 135;279-80.British journal of anaesthesia · 2025Article
- The role of environmental impact assessments in hospital care: Healthcare professionals' views on research and implementation priorities.Health research policy and systems · 2025Article
- A nationwide approach to reduction in anaesthetic gas use: the Dutch Approach to decarbonising anaesthesia. Comment on Br J Anaesth 2025; 134: 1146-52.British journal of anaesthesia · 2025Article
- The optimal mode of anaesthesia: are we ready for an evidence-based recommendation?British journal of anaesthesia · 2025Article
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Authors and funding
4 authors.
Funding
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Abstract
Anaesthetic gases account for ∼3% of the carbon footprint of the entire healthcare sector and up to 63% of the emissions originating from surgical care. Transitioning to predominant use of total intravenous anaesthesia (TIVA) has been proven a safe and effective strategy to reduce this footprint, yet its adoption has been slow in most countries. Interventions at the national level have been limited to regulatory action (e.g. banning of desflurane) and publication of nonbinding recommendations and best practices. We describe a new approach that we used to drive sustainable change and apply it to the debate between TIVA and inhalation anaesthesia at the national level. The Dutch Approach is founded on a bottom-up, self-regulatory model grounded in evidence-based practices. Patient safety studies, a national inventory of anaesthetic drug use, and in-depth interviews with anaesthetists were combined in developing a national guideline. Meeting the two main concerns among anaesthetists, patient safety and professional autonomy, the guideline requires all Dutch anaesthetic practices to adopt a local protocol whose main message is 'TIVA when possible, inhalation anaesthesia when necessary'. Central to the approach was the integration within the national quinquennial quality control audits. Adoption and implementation will be monitored and evaluated in an ongoing research project.
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