Anaesthesia and environment: impact of a green anaesthesia on economics.

Purpose of reviewThe excessive growth of the health sector has created an industry that, while promoting health, is now itself responsible for a significant part of global environmental pollution. The health crisis caused by climate change urges us to transform healthcare into a sustainable industry. This review aims to raise awareness about this issue and to provide practical and evidence-based recommendations for anaesthesiologists.Recent findingsWe offer seven recommendations for anaesthesiologists that want to transform their own practice.1. Use total intravenous anaesthesia over inhalation-based anaesthesia.2. Use ultra-low fresh gas flow (<0.5 l min-1) during inhalation based anaesthesia and higher flows (4-6 l min-1) during total intravenous anaesthesia.3. Anaesthetic gas capturing technology may have limited environmental benefit, while it increases cost.4. In the clinical setting, epidural or intravenous analgesia during labour is preferred over nitrous oxide inhalation.5. Properly designed air treatment systems save energy and reduce cost.6. Unoccupied set-back of air treatment systems can save up to 70% of energy.7. Reusable equipment is almost always associated with a lower environmental impact and lower costs compared with single-use disposables.This review offers evidence-based recommendations, along with their financial impact, to improve the sustainability of anaesthesiology practice in the operating room.