# Results and Future Perspectives of the Sustainable Anesthesia Project: A Large-Scale, Real-World Implementation Study at the Largest Spanish Private Healthcare Provider

## TL;DR

This study shows that changing anesthesia practices can significantly reduce healthcare-related greenhouse gas emissions.

## Contribution

The paper presents a large-scale real-world implementation of sustainable anesthesia practices leading to measurable emission reductions.

## Key findings

- Nitrous oxide and desflurane consumption decreased by 64% and 63%, respectively, in one year.
- Anaesthetic-gas emissions dropped by 54%, reducing the carbon footprint significantly.

## Abstract

Background: Climate change is a serious threat to global health. The healthcare sector contributes substantially to greenhouse gas (GHG) emissions, with anaesthetic gases being a major source of Scope 1 emissions. We aimed to evaluate the 2024 impact of the Sustainable Anesthesia Project, designed to reduce the environmental footprint of anaesthetic gases by eliminating and/or replacing the most polluting agents (nitrous oxide and desflurane) with more sustainable alternatives (sevoflurane, total intravenous anaesthesia, and regional/local anaesthesia). Methods: We conducted a descriptive analysis of anaesthetic gas consumption in 2023 and 2024, as well as a comparison of emissions in tons of CO2, the impact on the carbon footprint, and the potential future emissions savings that full implementation of the project would entail. Results: In the first year, nitrous oxide consumption decreased by 64% and desflurane by 63%. Overall anaesthetic-gas emissions fell by 8386 tCO2e versus 2023, a 54% relative reduction. Furthermore, the contribution of these gases to the total Scope 1 emissions markedly declined from 35.18% in 2023 to 21.22% in 2024. An additional reduction potential of around 4800 tCO2e was identified for consolidation by 2025 with full implementation. Conclusions: The results observed in this study demonstrate the success of the Sustainable Anesthesia Project, whose strategy represents an extensible and applicable option to other centers and companies in the health sector to reduce their environmental impact.