The review article by Forbes McGain and colleagues presents a comprehensive examination of the current state of environmental sustainability in the fields of anaesthesia and critical care. It addresses the significant impact of healthcare-related activities on the environment, notably through the emission of greenhouse gases and other pollutants.

Key Points:

• Atmospheric Impact of Anaesthetic Gases: The article discusses the global warming potential (GWP) of various anaesthetic gases, highlighting how gases like desflurane and nitrous oxide significantly contribute to global warming and ozone layer depletion.
• Life Cycle Assessment (LCA): LCA is utilized as a method to assess the environmental impact of healthcare practices from production to disposal. This includes studying the carbon footprint of both reusable and single-use anaesthetic devices.
• Waste Management: The article examines strategies for reducing waste in anaesthesia, such as using low-flow anaesthesia techniques and reprocessing single-use devices.
• Energy and Infrastructure: It stresses the importance of sustainable energy sources and efficient infrastructure in reducing the environmental footprint of healthcare facilities.
• Education and Advocacy: The review underscores the need for ongoing education and advocacy to promote environmental sustainability in healthcare practices.

Recommendations:

• Reduce Use of High GWP Anaesthetics: Shift towards using anaesthetics with lower GWPs and employ techniques like total intravenous anaesthesia (TIVA) where appropriate.
• Implement Waste Reduction Strategies: Enhance waste management practices to minimize the environmental impact, including recycling and the use of reprocessed devices.
• Advocate and Educate: Increase awareness and training among healthcare professionals regarding the environmental impacts of their practices and encourage sustainable practices.