Environment impact of inhaled anesthetics: A literature review

  • Jake Margulies, MSN, CRNA
  • Dirk Bahoravitch, MSN, CRNA
  • Shawn Collins, PhD, DNP, CRNA Western Carolina University
  • Ian Hewer, MSN, CRNA Western Carolina University


Current research demonstrates that increasing air pollution causes significant increases in cardiac disease, pulmonary disease, and even death. The known consequences of increasing greenhouse gases parallel those of air pollution and include higher rates of cardiovascular disease, asthma, and infectious disease. This literature review aimed to identify, assimilate, and summarize the known impacts of volatile anesthetics on the Earth’s environment. We present methods that are being used to reduce or eliminate these effects. We also aimed to summarize any known health effects on humans related to volatile anesthetic use and to review ways to reduce and eliminate these impacts. It is our hope that this review will provide evidence that leads to a change in current practice and future practice development that reduces the environmental impact and side effects related to volatile anesthetic use.


1. Certified Registered Nurse Anesthetists Fact Sheet. American Association of Nurse Anesthetists website. http://www.aana.com/ceandeducation/becomeacrna/Pages/Nurse-Anesthetists-at-a-Glance.aspx. Last updated August 26, 2016. Accessed January 3, 2016.
2. Andersen MPS, Nielsen OJ, Wallington TJ, Karpichev B, Sander SP. Assessing the impact on global climate from general anesthetic gases. Anesth Analg. 2012;114(5):1081-1085. http://dx.doi.org/10.1213/ANE.0b013e31824d6150.
3. Chung JW, Meltzer D. Estimate of the carbon footprint of the US health care sector. JAMA. 2009;302(18):1970-1972. http://dx.doi.org/10.1001/jama.2009.1610.
4. McGain F, Story D, Kayak E, Kashima Y, McAlister S. Workplace sustainability: the “Cradle to Grave” view of what we do. Anesth Analg. 2012;114(5):1134-1139. http://dx.doi.org/10.1213/ANE.0b013e31824ddfef.
5. Arranz MC, Munoz Moreno MF, Medina AA, Capitan MA, Vaquer FC, Gomez AA. Health impact assessment of air pollution in Valladolid, Spain [published online October 17, 2014]. BMJ Open. 2014;10. http://dx.doi.org/10.1136/bmjopen-2014-005999.
6. Protecting Health from Climate Change. World Health Organization. http://whqlibdoc.who.int/publications/2009/9789241598880_eng.pdf. Published 2009. Accessed January 3, 2016.
7. Climate change and human health. World Health Organization website. http://www.who.int/globalchange/en/. Published 2016. Accessed January 3, 2016.
8. Huncke TK, Ryan S, Hopf HW, et al. Greening the Operating Room: Reduce, Reuse, Recycle, and Redesign. Schaumburg, IL: American Society of Anesthesiologists; 2012.
9. Liftin K. Ozone Discourses: Science and Politics in Global Environmental Cooperation. New York, NY: Columbia University Press; 1994.
10. Ravishankara AR, Daniel JS, Portmann RW. Nitrous oxide: the dominant ozone-depleting substance emitted in the 21st century. Science. 2009;326(5949):123-125. http://dx.doi.org/10.1126/science.1176985.
11. Ryan S, Nielsen C. Global warming potential of inhaled anesthetics: application to clinical use. Anesth Analg. 2010;111:92-98.
12. Sherman J, Le C, Lamers V, Eckelman M. Life cycle greenhouse gas emissions of anesthetic drugs. Anesth Analg. 2012;114(5):1086-1090. http://dx.doi.org/10.1213/ANE.0b013e31824f6940.
13. Berry J, Barwise J, Lancaster L. Reclaiming waste anesthetic gas: initial clinical trials. Eur J Anaesthesiol. 2007;24(suppl 39):32. http://dx.doi.org/10.1097/00003643-200706001-00117.
14. Jänchen J, Brückner JB, Stach H. Adsorption of desflurane from the scavenging system during high-flow and minimal-flow aneasthesia by zeolites. Eur J Anaesthesiol. 1998;15(3):324-329. http://dx.doi.org/10.1097/00003643-199805000-00014.
15. Feldman J. Managing fresh gas flow to reduce environmental contamination. Anesth Analg. 2012;114(5):1093-1101. http://dx.doi.org/10.1213/ANE.0b013e31824eee0d.
16. Mankes R. Propofol wastage in anesthesia. Anesth Analg. 2012;114(5):1091-1092. http://dx.doi.org/10.1213/ANE.0b013e31824ea491.
17. Ryan S, Sherman J. Sustainable anesthesia. Anesth Analg. 2012;114(5):921-923. http://dx.doi.org/10.1213/ANE.0b013e31824fcea6.
18. Yasny JS, White J. Environmental implications of anesthetic gases. Anesth Prog. 2012;59(4):154-158. http://dx.doi.org/10.2344/0003-3006-59.4.154.
19. Costello A, Abbas M, Allen A, et al. Managing the health effects of climate change. Lancet. 2009;373(9676):1693-1733. http://dx.doi.org/10.1016/S0140-6736(09)60935-1.
How to Cite
MARGULIES, MSN, CRNA, Jake et al. Environment impact of inhaled anesthetics: A literature review. Anesthesia eJournal, [S.l.], v. 5, p. 1-4, mar. 2017. ISSN 2333-2611. Available at: <https://anesthesiaejournal.com/index.php/aej/article/view/58>. Date accessed: 22 june 2017.


environment; inhaled anesthetics; greenhouse gases