Sustainable Healthcare Practices in Pediatric Anesthesia.

BACKGROUND

Healthcare accounts for 4%-5% of global CO2 equivalent (CO2e) emissions, of which hospitals form a considerable component. Identifying evidence-based targets for carbon reduction in pediatric anesthesia can help guide meaningful reductions in healthcare-related environmental harm.

METHODS

A narrative review was conducted integrating published data on carbon emissions associated with anesthetic agents, perioperative workflows, waste generation, and hospital energy systems. Quantitative CO2e estimates were incorporated when available.

RESULTS

Preoperative strategies with measurable carbon savings include early anesthesia assessment, telehealth consultations, and standardization of diagnostic testing. Intraoperatively, avoidance of nitrous oxide and desflurane yield the largest individual reductions. Propofol waste can be reduced through dose calculators and optimized vial selection. Switching to reusable equipment further limits environmental harm. Institutional actions, including decommissioning nitrous oxide pipeline systems, enhancing sustainability training, and optimizing heating, ventilation, and air conditioning systems, offer the largest measurable carbon reductions.

CONCLUSIONS

Pediatric anesthetists can reduce environmental harm while optimizing patient care. While individual clinician choices -in particular avoiding desflurane and nitrous oxide use-are impactful, the largest and most sustainable emissions reductions derive from coordinated institutional and systems level changes.