Assessing the carbon footprint of inhalation anaesthesia, total intravenous anaesthesia, and spinal anaesthesia for a single surgical procedure: a prospective observational study.

Authors

Lina Lechani, Franck Verdonk, Daisy Daigné, Mathilde Maire, Davuth Tan, Amélie Cambriel, Natacha Kapandji, Emmanuel Pardo, Clémentine Taconet

Published in

British journal of anaesthesia. Aug 18, 2026. Epub Aug 18, 2026.

Abstract

Healthcare contributes substantially to greenhouse gas emissions (GHG), and anaesthesia is recognised as a high-impact sector. Evidence comparing the carbon footprint of anaesthetic techniques remains limited, particularly in Europe. We quantified carbon dioxide equivalent (CO₂e) emissions from inhalation anaesthesia with low-flow sevoflurane, TIVA and spinal anaesthesia during operative hysteroscopy.
We performed a prospective GHG-focused life cycle assessment of consecutive patients undergoing operative hysteroscopy in a French university hospital. For each case, we recorded gases, drugs, medical devices, electricity consumption, and their respective costs. Carbon footprints were calculated by Assistance Publique - Hôpitaux de Paris Carebone® platform and expressed in CO₂e.
We included 123 participants: 72 underwent inhalation anaesthesia, 22 underwent TIVA, and 29 underwent spinal anaesthesia. Total carbon emissions differed significantly across techniques: median emissions were 10.8 kgCO₂e [9.1-12.6] for inhalation anaesthesia, 6.6 kgCO₂e [6.4-6.9] for TIVA and 5.5 kgCO₂e [5.3-6.2] for spinal anaesthesia (P<0.001). Volatile anaesthetics were the main contributors for inhalation anaesthesia, pharmaceuticals for TIVA and single-use devices for spinal anaesthesia. Electricity consumption was similar across groups.
Spinal anaesthesia demonstrated the lowest carbon footprint. TIVA represented the lowest-carbon option for general anaesthesia techniques, whereas inhalation anaesthesia yielded the highest CO₂e emissions despite low-flow delivery. These findings highlight the mitigation potential of anaesthetic choice even in low-complexity procedures.

PMID:
42613204
Bibliographic data and abstract were imported from PubMed on 19 Aug 2026.

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