So when Woods first heard that some of the anesthetic gases she and her colleagues use to ease patients\u2019 pain are bad for the planet, she set out to change things. She presented the issue to the anesthesia department at the University of Pittsburgh Medical Center (UPMC), where she works, and her colleagues listened. \u201cThe chair of the department of anesthesia at Magee-Womens Hospital said, \u2018This is the nail in the coffin for desflurane,\u2019 and he proceeded to remove desflurane until its last use at Magee in 2013,\u201d she says. Desflurane is an anesthetic that is 2,540 times as potent a greenhouse gas as carbon dioxide<\/a>.<\/p>\n Woods didn\u2019t stop there. Along with several like-minded physicians at UPMC, she formed Clinicians for Climate Action<\/a> in 2022\u2014more than 500 clinicians are part of the group today\u2014and a year later, the group encouraged UPMC to launch its Center for Sustainability<\/a>.<\/p>\n The center hired an engineer, who calculated the hospital\u2019s greenhouse gas footprint from anesthetic gas use. That data gave the group powerful leverage to make the case for changing behavior<\/a>, Woods says. In 2024, UPMC banned the use of desflurane across all 40 hospitals in its vast western Pennsylvania network.<\/p>\n Anesthetist Joseph Ferriero, seen here standing beside an anesthesia machine at the University of Pittsburgh Medical Center Presbyterian hospital, has been instrumental in decarbonizing anesthesia throughout the UPMC system.<\/p>\n Credit: UPMC isn\u2019t the only one. A number of hospitals and health-care systems in the US, Canada, Europe, and Australia are starting to phase out desflurane. Across the Atlantic, Scotland banned desflurane anesthetics in 2023. And on Jan. 1 this year, the European Union prohibited its use unless medically necessary<\/a>. These efforts, often driven by medical professionals, are part of a growing push to cut the environmental impact of anesthesia\u2014whether by banning the worst offenders or reducing the use of others\u2014without altering the quality of patient care.<\/p>\n \u201cWhether you are in the car industry or in the airline industry<\/a> or hospitality, there are planetary health consequences to what you do,\u201d Woods says. \u201cAnd there are people in all these fields who care and who are trying to remediate the damage they do. I happen to be in health care. And these aren’t things that are part of being a physician, per se, but they’re part of being a global citizen.\u201d<\/p>\n The global harms of anesthetic gases<\/p>\n Globally, inhaled anesthetics are responsible for 3% of the total carbon footprint<\/a> of national health-care systems, according to the American Society of Anesthesiologists (ASA). These gases are critical for patient comfort and safety during medical procedures. But patients\u2019 bodies metabolize only about 5% of the anesthetic they breathe in through a mask; they exhale the rest of the gas, mostly unchanged, and it is vented into the atmosphere.<\/p>\n Those vented gases can have an outsized impact. The exact carbon emissions for hospitals vary, depending on emissions from electricity and heating, staff commutes, and whether a facility uses helicopters. But \u201canesthesia is a disproportionate contributor to a hospital\u2019s greenhouse gas footprint,\u201d says Douglas A. Colquhoun<\/a>, a professor in the University of Michigan (U-M) Medical School\u2019s Department of Anesthesiology. \u201cDepending on numbers, it\u2019s 6 to 10%, potentially, of a hospital\u2019s carbon dioxide footprint.\u201d<\/p>\n
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Desflurane<\/p>\n Mean alveolar concentration: 6.70%<\/p>\n Atmospheric lifetime: 14 years<\/p>\n Global warming potential*: 2,540<\/p>\n Equivalent auto miles** driven at anesthetic use of 1 L\/min per hour: 190<\/p>\n Isoflurane<\/p>\n Mean alveolar concentration: 1.20%<\/p>\n Atmospheric lifetime: 3.6 years<\/p>\n Global warming potential*: 539<\/p>\n Equivalent auto miles** driven at anesthetic use of 1 L\/min per hour: 8<\/p>\n Sevoflurane<\/p>\n Mean alveolar concentration: 2.20%<\/p>\n Atmospheric lifetime: 1.9 years<\/p>\n Global warming potential*: 144<\/p>\n Equivalent auto miles** driven at anesthetic use of 1 L\/min per hour: 4<\/p>\n
<\/p>\n Commonly used anesthetics, such as desflurane, sevoflurane, and isoflurane, are halogenated ethers and potent greenhouse gases<\/a>. The degree to which they warm the Earth\u2019s atmosphere depends on how much infrared radiation they absorb and how long they last in the atmosphere.<\/p>\n Desflurane is the biggest climate culprit. Each hour of its use produces the same warming potential as driving a gasoline-powered car for about 300 km. For sevoflurane, that number drops to around 6 km. These fluorinated gases also react with oxygen and water in the atmosphere to produce trifluoroacetic acid, a potentially harmful contaminant<\/a> that persists in the environment. Meanwhile, another major anesthetic, nitrous oxide<\/a>\u2014known as laughing gas\u2014is the next-worst planet-warming offender after desflurane and also depletes the ozone layer<\/a>.<\/p>\n The positive impact of anesthetic action<\/p>\n Bans on desflurane use are having a positive climate impact. Researchers at Lund University recently found that greenhouse gas impact from anesthetic gases has decreased by 27% between 2014 and 2023<\/a>. Globally switching to using just sevoflurane, they estimated, could have decreased the impact of anesthetics by 73% (Lancet Planet. Health 2025, DOI: 10.1016\/S2542-5196(25)00027-0).<\/p>\n In addition to switching to sevoflurane, many medical systems are cutting the volume of anesthetics they use.<\/p>\n Critically, this comes at no cost to patient care. To go under, patients breathe in anesthetic agents mixed with oxygen, air, and N2O in a closed circuit. Machines scrub CO2 from the exhaled air, add some fresh oxygen and anesthetic agent, and send the mixture back to the patient. It is possible to lower the flow of fresh gas added each time without affecting patient care. \u201cThis is just eliminating waste,\u201d says Lucinda Everett<\/a>, a pediatric anesthesiologist at Massachusetts General Hospital. \u201cIt does not result in providing less anesthesia to the patient.\u201d<\/p>\n “These aren’t things that are part of being a physician, per se, but they’re part of being a global citizen.”<\/p>\n Noe Woods, obstetrician-gynecologist, University of Pittsburgh Medical Center<\/p>\n Share A recent study by Colquhoun and his colleagues at U-M proved this with solid numbers<\/a> (Lancet Planet. Health 2025, DOI: 10.1016\/S2542-5196(24)00331-0).<\/p>\n The U-M medical system launched its Green Anesthesia Initiative in 2022. This included shifting to sevoflurane, reducing the use of N2O, and increasing the use of intravenous sedatives. Using electronic health-record data from before and after the initiative was launched, Colquhoun and colleagues measured the amount of anesthetic used, climate impact, and patient outcomes. The team found that the initiative halved CO2 emissions, saving the equivalent of 2.7 million km of driving in a standard passenger car, without compromising patient safety or outcomes.<\/p>\n Reducing desflurane use brings cost benefits as well. Liter for liter, the gas costs more than sevoflurane and isoflurane. And it requires an expensive, more complex delivery device.<\/p>\n Yet another low-hanging fruit up for grabs in minimizing a hospital\u2019s carbon footprint is changing the way N2O is distributed. Hospitals typically buy a big tank of N2O and put it in a central location, from where the gas is piped to various units. But, Woods says, \u201cnitrous oxide is a really tiny molecule, and it can seep out of things.\u201d<\/p>\n \u201cMultiple groups have shown that up to 90% of what is bought cannot be shown to be delivered to a patient, so it’s just leaking out to the environment,\u201d Colquhoun says. To reduce that leakage, several hospitals, including UPMC and Mass General, have stopped using centralized tanks and instead use small N2O cylinders at the anesthesia site.<\/p>\n A need for global alignment in anesthesia use<\/p>\n Many of the steps outlined above are listed in the ASA\u2019s 2024 guidelines to reduce health<\/a>care\u2019s environmental impact<\/a>: avoid desflurane and N2O unless necessary, cut fresh gas flows, and move to portable N2O tanks.<\/p>\n Newer waste-gas capture and photochemical destruction technologies seem promising, the guidelines say, but they need more validation. For now, the ASA encourages focusing on reducing anesthetic use and emissions.<\/p>\n
A wider global conversation might be necessary. The Lund University study found that while desflurane use is going down in some countries, in others, such as Japan, China, India, and Russia, its use is on the rise.<\/p>\n In the end, patient comfort is the number one priority for doctors. For certain clinical applications, such as pediatric care and labor and delivery, clinicians say there is no substitute for inhaled anesthetics.<\/p>\n \u201cWe’re lucky to have a lot of different options for anesthetic medications currently, some of which are intravenous,\u201d Everett says. \u201cBut there are specific situations where anesthesia gases might be preferable.\u201d Each gas has particular properties that might be more suitable for a given patient or situation, she adds. \u201cBut whichever gas we might choose, standard practice in the past was very wasteful, and there are ways to use them more responsibly.\u201d<\/p>\n![\"A](\"https:\/\/www.newsbeep.com\/ie\/wp-content\/uploads\/2026\/04\/Feature--Hospitals-are-switching-anesthetics-to-cut-greenhouse-gas-emissions---387995.webp\")
\n A person wearing a face mask and head covering stands beside a counter containing various pieces of medical equipment, including IV bags and two screens that display data curves.<\/p>\n
\n University of Pittsburgh Medical Center<\/p>\n
\n Packing a punch
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\n These common inhaled anesthetics, all fluorinated ethers, are potent greenhouse gases.
<\/p>\n![\"Desflurane\"](\"https:\/\/www.newsbeep.com\/ie\/wp-content\/uploads\/2026\/04\/desflurane.jpg\")
<\/p>\n![\"Isoflurane\"](\"https:\/\/www.newsbeep.com\/ie\/wp-content\/uploads\/2026\/04\/isoflurane.jpg\")
<\/p>\n![\"Sevoflurane\"](\"https:\/\/www.newsbeep.com\/ie\/wp-content\/uploads\/2026\/04\/sevoflurane.jpg\")
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\n *GWP100; global warming potential relative to carbon dioxide over a 100-year period.
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\n **Based on EPA 2022 emission factor of 4.03 x 10-4 metric tons of CO2-equivalent\/mile.
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\n Knockout nations
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\n Countries with highest greenhouse gas impact of halogenated anesthetic agents from medical use in 2023.
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