The article explores the environmental impacts of anesthetic drugs through a comprehensive life cycle assessment (LCA), focusing on five common anesthetics: sevoflurane, desflurane, isoflurane, nitrous oxide (N2O), and propofol. This analysis includes all stages from production to disposal, highlighting the significant greenhouse gas (GHG) emissions associated with these drugs, especially when compared across different use scenarios.

Key Findings:

• GHG Emissions by Drug: Desflurane and N2O are identified as having notably high global warming potentials (GWPs), with desflurane generating the most substantial impact—up to 15 to 20 times more than sevoflurane and isoflurane respectively, when used in a mixture with oxygen and air.
• Propofol’s Lower Impact: Propofol demonstrates significantly lower GHG impacts, primarily due to its administration method that does not involve direct emissions. Its environmental impact mainly comes from the energy used in syringe pumps.
• Role of Usage Methods: The assessment underscores how different methods of administering these drugs (e.g., low-flow techniques and avoiding N2O) can mitigate their environmental footprint.

Environmental Impact Mitigation Strategies:

• The article suggests restricting high-GWP anesthetics like desflurane and N2O unless their clinical benefits decisively outweigh their environmental costs.
• Emphasizing waste anesthetic gas capture technologies and low fresh gas flow rates as strategies to reduce GHG emissions.
• Consideration of alternative anesthesia methods that have less environmental impact, such as total intravenous anesthesia (TIVA) or regional anesthesia techniques.