Healing the Patient, Protecting the Planet: The Practice and Paradigm of Green Anaesthesia

Abstract

Healthcare systems globally confront a profound paradox: the delivery of medical care inadvertently drives environmental degradation, contributing approximately 4–5% of global greenhouse gas (GHG) emissions. Within this ecosystem, the operating theatre acts as a hyper-intensive carbon epicenter, with clinical anaesthesia bearing a disproportionate ecological footprint. This article comprehensively reviews the paradigm of "Green Anaesthesia"—an evidence-based approach to mitigating the environmental impact of perioperative care without compromising patient outcomes. We examine the atmospheric dynamics of halogenated volatile anaesthetics (desflurane, isoflurane, sevoflurane) and nitrous oxide (N₂O), emphasizing their respective global warming potentials (GWP) and life-cycle assessments (LCAs).

Clinical mitigation strategies-including ultra-low-flow anaesthesia, total intravenous anaesthesia (TIVA), and regional anaesthesia-are appraised alongside structural interventions across Scope 1, 2, and 3 emissions. Global consensus mandates from the World Federation of Societies of Anaesthesiologists (WFSA), the European Society of Anaesthesiology and Intensive Care (ESAIC), and recent national guidelines provide a standardized operational blueprint. Finally, this paper addresses systemic structural and behavioral barriers to widespread adoption, mapping out a collaborative roadmap to reconcile patient safety with planetary health.