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Less inhaled anaesthetics, less greenhouse gas emission
Getinge is driving sustainability in operating theatres and is calling on NHS hospitals to prioritise anaesthetic gas reduction and recycling, through innovative approaches.
Volatile anaesthetic agents are powerful greenhouse gases released into the atmosphere during every procedure. Reducing their use is therefore an urgent ecological priority. One increasingly popular and innovative strategy is the recycling of anaesthetic gases. But why does it still make sense to prioritise reduction over recycling – and how can this be achieved safely and effectively using low-flow anaesthesia?
Time to act Volatile anaesthetics are responsible for up to 35% of a hospital’s greenhouse gas emissions,1 making them a significant environmental concern. While the average individual emits about 11 tonnes of CO2
per year, anaesthetists
reach occupational emission levels of up to 17.1 tonnes per person annually.2
For example,
during a 7-hour procedure with a fresh gas flow of 2 litres per minute, the use of highly polluting agents like desflurane or nitrous oxide can result in a carbon footprint equivalent to driving from
Norway to South Africa.3,4
In addition, volatile anaesthetics pose occupational health risks for OR staff exposed to escaping gases. This leakage also requires constant adjustment of gas delivery, leading to increased consumption and added costs. It’s clearly time for hospitals and anaesthetists to take action.
Recycling anaesthetic gases: turning waste into value Traditionally, anaesthetic gases are scavenged at the anaesthesia machine and vented directly into the atmosphere. However, new capture systems offer a promising alternative. In these setups, exhaled gases are filtered, collected, and prepared for reuse using activated charcoal filters connected to the anaesthesia device. However, questions remain about how much
of the delivered anaesthetic gas is actually captured perioperatively and can be recycled.5,6 2022 study found that only 25% of desflurane was
A
captured by the charcoal filter – with most of the gas still escaping into the atmosphere. The authors suggest that at the time of extubation, patients may still retain significant amounts of anaesthetic agents, which are then exhaled into the room air.7 Recycling is therefore a promising measure
to reduce hospital greenhouse gas emissions – but further research is needed to assess its effectiveness.8
Reduce first, then recycle The European Society of Anesthesiology and Intensive Care (ESAIC), The German Society of Anesthesiology and Intensive Care Medicine (DGAI) and the Professional Association of German Anaesthetists (BDA) offer specific recommendations for sustainable anaesthesia.9 These include: l Avoiding desflurane as much as possible l Preferring sevoflurane due to its lower global warming potential
l Choosing total intravenous anaesthesia (TIVA) or regional anaesthesia
l Consistently applying minimal-flow anaesthesia to reduce anaesthetic agent use.10
A two-step strategy – reducing the use of volatile agents first, then recycling what is still used – makes sense for several reasons: l Lower gas use leads directly to cost savings by reducing procurement needs
l What isn’t consumed doesn’t need to be recycled
l Less gas consumption means less exposure and emissions
l Even if recycling proves only partially effective, less residual gas escapes into the atmosphere
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www.clinicalservicesjournal.com I December 2025
www.clinicalservicesjournal.com Volume 24 I Issue 11 I December 2025
THE CLINICAL SERVICES JOURNAL
Sustainability special focus
Innovation: the role of clinical engineering
Advancing excellence in ultrasound
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