Useful resources

  • The Sus-Op Network is for everyone interested in improving the environmental sustainability of operating theatres Sustainable Operating Theatres
  • Dr Tom Pierce has created an Excel ® Version of CO2e and cost calculator of inhalational anaesthesia The calculator allows comparison of both financial cost and carbon dioxide equivalence (CO2e) of inhalational anaesthesia. By completing the cells the calculator provides a graphical comparison of cost and CO2e as well as allowing inter-agent comparison. The calculator is a tool that permits financial and environmental comparison between inhalational techniques. The calculator is available to download on Android and Apple devices. Find out more>> Download the calculator>>
  • What can you do? Dr Tom Pierce, member of the AAGBI Environmental Task Group, has recently written an article in the RCoA Bulletin more specifically about how anaesthetists can get involved in sustainable healthcare - See page 39. Download PDF »
  • Yale Gassing Greener Anesthesia provider calculator
  • Yale Gassing Greener Nitrous oxide provider calculator
  • Yale Gassing Greener Clinician survey
  • Sneyd JR, Montgomery H, Pencheon D. The anaesthetist and the environment. Anaesthesia 2010; 65: 435-7.
  • Montgomery H. The medical impact of climate change. RCoA Bulletin 2008; 49: 2485–8.
  • King H. Waste not, want not: reducing the carbon footprint in anaesthesia. RCoA Bulletin 2010; 60: 46-8.
  • Griffiths J, Adshead F, Rao M, Thorpe A. (Eds). The health practitioner’s guide to climate change. Earthscan Ltd, London, 2009.
  • Sherman, J. Achieving Ecological Sustainability In Anesthesiology. Anesthesiology News 2017; 43: 31-33. Download PDF »
Anaesthetic gasses/inhalational agents
  • Axelson U. Climate impact of anaesthetic gases 2008. Download PDF » 
  • Smith I. Nitrous oxide in ambulatory anaesthesia: does it have a place in day surgical anaesthesia or is it just a threat for personnel and the global environment? Current opinion in anaesthesiology 2006; 19: 592-6.
  • Parker NW, Behringer EC. Nitrous oxide: a global toxicological effect to consider. Anesthesiology 2009; 110: 1195.
  • McGain F. Why anaesthetists should no longer use nitrous oxide. Anaesthesia and Intensive Care 2007; 35: 808-9
  • Langbein T, Sonntag H, Trapp D et al. Volatile anaesthetics and the atmosphere: atmospheric lifetimes and atmospheric effects of halothane, enflurane, isoflurane, desflurane and sevoflurane. British Journal of Anaesthesia 1999; 82: 66-73. 
  • Shine KP. Climate effect of inhaled anaesthetics. British Journal of Anaesthesia 2010; 105: 731-3. 
  • Charlesworth M. How green is your gas? Anaesthesia News 2009; 267: 22-23.
  • Sulbaek Anderson MP, Sander SP et al. Inhalation anaesthetics and climate change. British Journal of Anaesthesia 2010; 105: 760-6.
  • Ishizawa Y. Special article: general anesthetic gases and the global environment. Anesthesia and Analgesia 2011; 112: 213-7.
  • Ryan SM, Nielsen CJ. Global warming potential of inhaled anesthetics: application to clinical use. Anesthesia and Analgesia 2010; 111: 92-8.
Other drugs
  • Stockholm County Council. 2011. Environmentally classified pharmaceuticals.
    Download PDF »
  • Apoteket AB (The National Corporation of Swedish Pharmacies), Stockholm County
  • Council and Stockholm University. Environment and pharmaceuticals. April, 2006. Download PDF »
Waste management
  • Hutchings D, White SM. Coming round to recycling.  British Medical Journal 2009; 338: b609.
  • McGain F, Clark M, Williams T, Wardlaw T. Recycling plastics from the operating suite. Anaesthesia and Intensive Care 2008; 36: 913-4.
  • McGain F, Story D, Hendel S. An audit of intensive care unit recyclable waste. Anaesthesia 2009; 64: 1299-302.
  • McGain F, McAlister S, McGavin A, Story D.The financial and environmental costs of reusable and single-use plastic anaesthetic drug trays. Anaesthesia and Intensive Care 2010; 38: 538-44.
  • Gwynne-Hellier RM, Uncles D. Going the extra mile: an evaluation of the global impact of single use disposable equipment available in one operating theatre in a district general hospital. Abstract presented at AAGBI Annual Conference, 2010.
  • Gaiser RR, Cheek TG, Gutsche BB. Glass recycling in the labour suite is environmentally sound and economical. British Journal of Anaesthesia 2004; 92: 584-6. 
  • Goldberg ME, Vekeman D, Torjman MC, Seltzer JL, Kynes T. Medical waste in the environment: do anesthesia personnel have a role to play? Journal of Clinical Anaesthesia 1996; 8: 475-9. 
  • Seidman PA, Parker BM. Sharps disposal in the operating room: current clinical practices and costs. Anesthesia and Analgesia 1998; 87: 634-6. 
  • Kole TE. Reduce, reuse and recycle in the anesthesia workplace. AANA J 1992; 60: 109-12.
  • Lee RC, Berzins S, Alfieri N. Single-use device reuse risks. Can J Infect Control 2007; 22: 142-6. 
  • Tudor TL, Noonan CL, Jenkin LE. Healthcare waste management: a case study from the National Health Service in Cornwall, United Kingdom. Waste Management 2005; 25: 606-15. 
  • Paul A, Strout P. Waste abatement: recycling, disposal practices can cut costs. Journal of Healthcare Resource Management 1997;15: 26-9. 
Energy use
  • Chakladar A, White SM. Unnecessary electricity consumption by anaesthetic room monitors. Anaesthesia 2010; 65: 754-5.
  • Chakladar A, White SM, Eckstein S. Paper use in research ethics applications and study conduct. Clinical Medicine 2011; 11: 44-7.