The Hidden Climate Hotspot in Surgery: Anesthesia Gases

For many inhaled anesthetic gases, very little is metabolized. So a lot of what’s delivered ends up getting exhausted/vented out (for staff safety), and not processed. They go up and out into the atmosphere.

In the third episode of the Greener Hospitals, Healthier Futures series, I sat down with Dr. Prabhakar Devavaram, Director of Environmental Sustainability in the Division of Peri-operative Anesthesia and a pediatric anesthesiologist at Boston Children’s Hospital. He’s also the site principal investigator for Project SPRUCE, a multicenter trial to reduce anesthetic greenhouse gas emissions. 

Prabhakar’s cared about this topic for some time, and shares not only how Boston Children’s Hospital is going about reducing their anesthetic climate impact, but also dives into what these gases are, the various types, and how they’re used. 

Did you know that nitrous oxide (laughing gas) can linger in the atmosphere for ~114 years! And very little is metabolized at all. Nitrous oxide is especially relevant in pediatrics, where it’s often used to help kids feel comfortable during mask induction, before adding other agents. 

Prabhakar teaches us how anesthesiologists can reduce their climate impact by using non-inhaled alternatives when possible, low-flow options, checking for leaks, and how to make smarter decisions in patient care. He also shares a surprising systems fix: a big chunk of nitrous emissions can happen before it ever reaches the patient. It’s lost through central piping and leaks. Switching to point-of-use cylinders (and tightening the system) can dramatically reduce waste.

In this episode you’ll learn: 

• Understand the main anesthetic gases and their climate impact

• Learn practical levers (alternatives, low-flow, leak reduction)

• See how hospitals operationalize change (systems & workflow)

• Discover how data and feedback loops shift clinician behavior

Mentions: 

• Project SPRUCE 

• Joint Commission “Reducing the Environmental Impact of Anesthetic Gases” + Seattle Children’s Project SPRUCE reference 

• ASA Environmental Sustainability: “Environmental Impact of Inhaled Anesthetics” (clear, clinician-friendly guidance) 

• Association of Anaesthetists “Guide to green anaesthesia”

• Practice Greenhealth anesthetic gas how-to toolkit (PDF) 

• Health Sector Climate Pledge (waste anesthetic gases explicitly called out) 

• Ether Dome background (Mass General Museum page) 
  

Credits:🎙 Any Job Can Be a Climate Job is produced and hosted by Louisa Henry. Edited by Alex Leff. Original music by Run Riot Run. Logo design by Cassidy Frost. Image attribution: vecteezy.com.Subscribe for more episodes on how real people are driving climate impact through their everyday work. Found here, Substack, or wherever you get your podcasts.