Principles of environmentally‐sustainable anaesthesia: a global consensus statement from the World Federation of Societies of Anaesthesiologists

Abstract

The Earth's mean surface temperature is already approximately 1.1°C higher than pre-industrial levels. Exceeding a mean 1.5°C rise by 2050 will make global adaptation to the consequences of climate change less possible. To protect public health, anaesthesia providers need to reduce the contribution their practice makes to global warming. We convened a Working Group of 45 anaesthesia providers with a recognised interest in sustainability, and used a three-stage modified Delphi consensus process to agree on principles of environmentally sustainable anaesthesia that are achievable worldwide. The Working Group agreed on the following three important underlying statements: patient safety should not be compromised by sustainable anaesthetic practices; high-, middle-and low-income countries should support each other appropriately in delivering sustainable healthcare (including anaesthesia); and healthcare systems should be mandated to reduce their contribution to global warming. We set out seven fundamental principles to guide anaesthesia providers in the move to environmentally sustainable practice, including: choice of medications and equipment; minimising waste and overuse of resources; and addressing environmental sustainability in anaesthetists' education, research, quality improvement and local healthcare leadership activities. These changes are achievable with minimal material resource and financial investment, and should undergo re-evaluation and updates as better evidence is published. This paper discusses each principle individually, and directs readers towards further important references.

Action guidance for addressing pollution from inhalational anaesthetics

“…Professional guidelines and checklists on how to reduce the environmental footprint of anaesthetic practice are provided by several professional organisations including the World Federation of Societies of Anaesthesiologists [14], American Society of Anesthesiologists [15], Association of Anaesthetists [16] and the Australian and New Zealand College of Anaesthetists [17].…”

What can anaesthetists do to help combat the global climate emergency?

“…Indeed, anaesthetic gases and volatile agents alone account for 5% of the carbon footprint of acute NHS organisations [10], and there are many other areas where anaesthesia providers can make informed choices affecting the environmental impact of their practice [11]. In a recent issue of Anaesthesia, White et al presented a global consensus statement on the principles of environmentally sustainable anaesthesia on behalf of the World Federation of Societies of Anaesthesiologists [12]. In this editorial, we examine this consensus statement, particularly in the context of the COP26 conference and the IPCC's sixth assessment report [1].…”

“…CA is a past Association of Anaesthetists' Fellow in environmentally sustainable anaesthesia and was a member of the broader working group for the consensus statement [12]. AS is an Editor of Anaesthesia .…”

Greener Operations: a James Lind Alliance Priority Setting Partnership on environmentally sustainable peri-operative practice

“…3 Recently, healthcare systems, educational regulators and professional societies have begun to issue guidelines and implement plans aiming to mitigate the carbon footprint and ecological impacts of healthcare. [4][5][6][7][8][9] This rapid expansion of interest in the area is both necessary and welcome but presents its own challenges. Though there are several highimpact measures that should be urgently implemented (e.g., decarbonisation of electricity production), 4 it is universally acknowledged that achieving sustainable healthcare will require research and innovation.…”

“…Though there are several highimpact measures that should be urgently implemented (e.g., decarbonisation of electricity production), 4 it is universally acknowledged that achieving sustainable healthcare will require research and innovation. [4][5][6] Between 220 and 344 million operations are thought to be performed worldwide every year, 10 a number which will increase as the Lancet Commission on Global Surgery target of 5,000 operations per 100,000 population is approached. 11 The peri-operative journey, from initial consultation to surgery and then discharge from hospital and recovery, is a complex process that involves many groups of hospital staff.…”