Hospital’s anesthesia reforms slash carbon footprint, expenses

Editor's Note

Universitätsmedizin Berlin reduced anesthesia-related carbon emissions by more than 80% since 2018 by eliminating high-impact anesthetic gases, implementing education initiatives, and revising clinical guidelines, according to a February 27 report in Medical Xpress.

The hospital’s efforts targeted desflurane, an anesthetic gas with an extreme climate impact—nearly 8,000 times greater than carbon dioxide over five years, the outlet reports. Leaders introduced extensive education for anesthesiologists and revised anesthesia protocols, ultimately eliminating desflurane throughout the Charité health system by late 2023.

In place of desflurane, anesthesiologists increasingly use intravenous propofol, which has a significantly lower environmental impact. When inhaled anesthetics are necessary, they administer sevoflurane via the "minimal flow" technique to reduce emissions. These changes led to a reduction in anesthesia-related carbon emissions from over 7,500 metric tons in 2018 to 1,454 metric tons in 2023—equivalent to the annual emissions of approximately 300 German households, Medical Xpress reports.

The efforts also have reduced costs. As detailed in the article, desflurane is among the most expensive anesthetics. Eliminating it contributed to nearly a 50% drop in anesthetic agent costs between 2015 and 2023.  

Full details were published in Anesthesia & Analgesia. According to the study, education and awareness campaigns contributed to emission reductions, but the most impactful change came from formal management decisions that established new, standardized anesthesia practices. Researchers emphasized that top-down leadership is essential for driving lasting, system-wide sustainability improvements in perioperative care.