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TOPLINE:

An analysis of greenhouse gas emissions from volatile anesthetic agents across 41 countries showed that Western nations have achieved significant reductions, but Asian countries continue to increase their use of the agents. South Korea and Japan reported the highest global per capita emissions.

METHODOLOGY:

• Researchers conducted a multicounty analysis to estimate greenhouse gas emissions from volatile anesthetics using sales data obtained from IQVIA MIDAS and national medicines agencies.
• They calculated kilograms of carbon dioxide (CO₂) equivalents per capita as an indicator of greenhouse gas emissions focusing on sales of desflurane, isoflurane, and sevoflurane in 41 countries, representing approximately 35% of the global population.
• The analysis compared emissions among 27 nations in the European Union with those among other Western countries like Australia, Canada, New Zealand, the UK, and the US.
• Emissions among Asian countries such as China, Hong Kong, Japan, Malaysia, South Korea, Singapore, Taiwan, and Thailand were also analyzed.
• Time trends and percentage changes in greenhouse gas emissions related to the procurement of volatile anesthetics from 2018 to 2023 were presented for all the groups.

TAKEAWAY:

• Canada, New Zealand, and the UK showed a 65%-95% reduction in CO₂ equivalent emissions, achieving levels below 0.5 kg of CO₂ equivalents per inhabitant by 2023. Australia and the United States, despite reductions, still had higher levels of emissions.
• Asian countries saw substantial increases in emissions related to volatile anesthetics, with South Korea and Japan having approximately 2.5 kg of CO₂ equivalents per inhabitant in 2023 and China experiencing a 130% rise in emissions from 2018 to 2023.
• Emissions also increased from 2018 to 2023 in some countries, including Malta, Serbia, the Czech Republic, and the Russian Federation.
• Trends in emissions varied across Europe; Northern countries like Finland, Norway, and the UK showed a reduction in emissions from 1-2 kg to less than 0.5 kg of CO₂ equivalents per inhabitant, whereas Denmark and Estonia maintained low levels of emissions. Italy, Portugal, and Spain saw minimal reductions.

IN PRACTICE:

“The experience of nations that were receptive to awareness campaigns and phased out desflurane use show that reducing emissions below 0.5 kg of CO₂e [equivalents] per inhabitant is attainable. This success should serve as a model for all the other countries, prompting them to implement educational initiatives for anaesthetists and adopt specific policies to mitigate emissions from inhalational anaesthetics,” the researchers reported.

SOURCE:

The study was led by Marta Caviglia, of the Centre for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, at the Università del Piemonte Orientale in Novara, Italy. It was published online on August 6, 2025, in Anaesthesia.

LIMITATIONS:

The study considered only greenhouse gas emissions from atmospheric release of volatile anesthetic agents, not accounting for emissions during production, packaging, transport, storage, and disposal phases. While data were available for 41 countries, there was clear overrepresentation of high-income nations, with incomplete or unavailable data from South America, Africa, and some Asian countries, including India. The analysis did not account for nitrous oxide emissions.

DISCLOSURES:

No external funding or competing interests were declared by the authors.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.