to main content Sustainable Health Care Resource Center: Anesthetic Gases | The Joint Commission

Anesthetic Gases

Effective maintenance of anesthetic supplies and equipment can reduce wasteful usage, lowering greenhouse gas emissions and costs.

Strategies and Practices

  • Conduct regular monitoring of airborne concentrations of waste gas
  • Minimize fresh gas flow rates; switch to low flow or closed anesthesia systems
  • Utilize efficient ventilation and scavenging systems
  • Ensure anesthesia equipment is well-maintained without leaks
  • Decommission or avoid construction of central nitrous oxide piping
  • Portable E cylinders should be substituted in those locations where nitrous oxide use is considered essential
  • Select anesthetic agents with lower GHG emissions (remove desflurane from formularies)
  • Consider total intravenous anesthesia (TIVA) as an alternative to volatile/inhaled anesthetics
  • Follow appropriate procedures for the disposal of IV anesthetics
  • Switch to metered-dose inhaler alternatives (e.g., soft mist or dry powder)

Sources: Devlin-Hegedus, JA (2022), AHRQ Primer, National Academy of Medicine Climate Collaborative, Practice Greenhealth

Sign up to get full access to the Spotlights and Cost Savings resources.