Observational studyBritish journal of anaesthesia2025
The carbon footprint of general anaesthesia in adult patients: a multicentre observational comparison of intravenous and inhalation anaesthetic strategies in 35,242 procedures.
Observational study in British journal of anaesthesia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06111248 (Evaluation of the Impact of Training Healthcare Teams), which is not on this map. Cited by 10 papers.
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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.
Evaluation of the Impact of Training Healthcare Teams (Quality Improvement Project) in the Combined Use of AoA Carestation Software and Digital Intraoperative Monitoring Tools (State Entropy, Surgical Pleth Index and Train-of-Four) During General Anesthesia for Intermediate- or Major-risk Surgery on Patient Morbidity and Mortality at 28 Days
Who cites it
10 citing papers in PubMed.
- Sustainable anaesthesia: beyond carbon and towards system-level change.Anaesthesia · 2026Article
- Environmental and clinical rationale for the use of desflurane: a review of the literature.Journal of anesthesia · 2026Review
- Exploring sevoflurane consumption and COJournal of clinical monitoring and computing · 2026Article
- Beyond the equation: transparency and verification in pharmacokinetic-pharmacodynamic model implementation for target-controlled infusion.Journal of clinical monitoring and computing · 2026Article
- Recycling and Environmental Sustainability in Anesthesia Practice: Beyond Low‑Flow Anesthesia.Cureus · 2026Review
- Applying Abstract Text Mining as a Complement to PRISMA in Reviewing the Scope of Healthcare's Circular Economy Comment on "A Review of the Applicability of Current Green Practices in Healthcare Facilities".International journal of health policy and management · 2026Article
- The afterlife of propofol: a survey of propofol disposal in French hospitals.British journal of anaesthesia · 2025Article
- Implementing sustainable anaesthesia: challenges and opportunities in education.British journal of anaesthesia · 2025Article
- Assessing the environmental impact of propofol use in anaesthesia: a call for surveillance monitoring.British journal of anaesthesia · 2025Article
- The optimal mode of anaesthesia: are we ready for an evidence-based recommendation?British journal of anaesthesia · 2025Article
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundGeneral anaesthesia is a significant contributor to healthcare-related greenhouse gas (GHG) emissions. Previous studies have compared non-optimised anaesthesia strategies (desflurane, nitrous oxide, or both) to evaluate the impact of green initiatives on reducing the carbon footprint of anaesthesia. However, modern halogenated anaesthesia techniques, including low fresh gas flow and target-controlled inhalation anaesthesia (TCIA), offer potentially more environmentally friendly alternatives. Thus, we aimed to compare the GHG emissions of total intravenous anaesthesia (TIVA) with these newer techniques.
methodsThis multicentre study compared GHG emissions per hour of general anaesthesia in adult surgical patients between three anaesthetic strategies: TIVA with propofol, sevoflurane in TCIA mode, and manually optimised sevoflurane. The study was conducted in three French university hospitals, each using one anaesthesia strategy. The quantity of anaesthetic drugs used was obtained from pharmacy procurement records and converted to carbon dioxide equivalents (CO
resultsTCIA, manually optimised sevoflurane, and TIVA strategies were used in 7873, 15 461, and 10 717 anaesthetics, respectively. The carbon footprint of the principal anaesthetic drugs per hour of anaesthesia was significantly lower in the TIVA strategy, at 0.4 kg CO
conclusionsTIVA with propofol was the most effective approach for minimising greenhouse gas emissions in anaesthesia practices. However, if TIVA were used exclusively globally, it could lead to issues such as stock depletion, plastic pollution, and water contamination.
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