Environmental and economic impact of sustainable anaesthesia interventions: a single-centre retrospective observational study

Background Anaesthesia contributes substantially to the environmental impact of healthcare. To reduce the ecological footprint of anaesthesia, a set of sustainability interventions was implemented in the University Hospital Zurich, Switzerland. This study evaluates the environmental and economic implications of these interventions. Methods This was a single-centre retrospective observational study. We analysed the environmental impact and financial implications of changes in sevoflurane, desflurane, propofol, and plastic consumption over 2 yr (April 2021 to March 2023). The study included pre-implementation, implementation, and post-implementation phases. Results After implementation of sustainability measures, desflurane use was eliminated, there was a decrease in the consumption of sevoflurane from a median (inter-quartile range) of 25 (14–39) ml per case to 11 (6–22) ml per case (P<0.0001). Propofol consumption increased from 250 (150–721) mg per case to 743 (370–1284) mg per case (P<0.0001). Use of plastics changed: in the first quarter analysed, two or more infusion syringes were used in 62% of cases, compared with 74% of cases in the last quarter (P<0.0001). Two or more infusion lines were used in 58% of cases in the first quarter analysed, compared with 68% of cases in the last quarter (P<0.0001). This resulted in an 81% reduction in overall environmental impact from 3 (0–7) to 1 (0–3) CO2 equivalents in kg per case (P<0.0001). The costs during the final study phase were 11% lower compared with those in the initial phase: from 25 (13–41) to 21 (14–31) CHF (Swiss francs) per case (P<0.0001). Conclusions Implementing sustainable anaesthesia interventions can significantly reduce the environmental impact and cost of anaesthesia.