Abandoning desflurane is just part of the solution to anaesthesia sustainability.

Eliminating desflurane in anaesthesia practice contributes to a significant savings of carbon dioxide emissions. Seibold and colleagues evaluated the carbon footprint of a step-wise approach to eliminating desflurane over an 8-year period in their retrospective cohort study using individual patient data. They also explored the wide variability in individual providers' likelihood of having high carbon dioxide emissions in their patients. Although desflurane is an important source of contribution to carbon footprint in healthcare, many sustainable anaesthesia practices are also very important, which require simultaneous focus, such as reduction of fresh gas flow, avoidance of nitrous oxide, preferential use of reusable devices, and being resource conscious during our clinical practice. Collectively, anaesthesiologists make an impact using a holistic approach to practice sustainable anaesthesia: it is a package!