LibGuides: Nurse Anesthesia Practice Research Guide: Green Anesthesia Resources

Green Anesthesia Web Resources

Anesthetic Gases: Guidelines for Workplace Exposures
From the United States Department of Labor Occupational Health and Safety website.
Climate Change and Health
A fact sheet from the World Health Organization.
Disability-Adjusted Life Years
A fact sheet from the World Health Organization.
Environmentally Classified Pharmaceuticals
From the Stockholm City Council.
Fifth Assessment Report
From the Intergovernmental Panel on Climate Change (IPCC).
Global Climate Change: Vital Signs of the Planet (NASA)
Greenhealth Academy
Provides webinars and other educational materials on sustainable health care. Membership may be required to access some resources.
Health-care Waste Fact Sheet
From the World Health Organization.
Health Care Climate Council
Health Care Without Harm
Overview of Greenhouse Gases (EPA)
From the Environmental Protection Agency.
Practice Greenhealth
Reducing the Carbon Footprint of Anesthetic Gases
Video recording of the presentation given by Dr JMT Pierce, Environment and Sustainability Advisor at the Royal College of Anesthetists (RCoA – UK) and Consultant Anesthetist for the University Hospital Southampton (UK). From the Global Green and Healthy Hospitals website, a project of Health Care Without Harm.
Stryker Sustainability Solutions
Single-use medical device reprocessing and remanufacturing company.
Sustainability Roadmap for Hospitals
Understanding Global Warming Potentials
From the Environmental Protection Agency.
Yale Center on Climate Change and Health: Inhaled Anesthesia Climate Initiative
Yale Sustainability

Green Anesthesia Articles

These links go to publisher / society websites where the article is published online or the content is labeled open access / open archive.

Atmospheric science, anaesthesia, and the environment
From BJA Education.
Effects Of Surgery On A Warming Planet: Can Anesthesia Go Green?
From NPR.
Environmental Impacts of the U.S. Health Care System and Effects on Public Health
From PLOS ONE.
Greening the operating room and perioperative area: Environmental sustainability for anesthesia practice
From the American Society of Anesthesiologists.
The impact of surgery on global climate: a carbon footprinting study of operating theatres in three health systems
From The Lancet Planetary Health.
An initiative to optimize waste streams in the operating room: Recycling in the operating room (RECOR) project
From AANA Journal.
The Lancet Commission on global mental health and sustainable development
From The Lancet.
Operating Room Waste Reduction
From AANA Journal.
Reusable vs. Disposable Laryngoscopes
From the Anesthesia Patient Safety Foundation.
Strategies for sustainability: Going green in the OR
From the Bulletin of the American College of Surgeons.

These links will take you to the article indexed in PubMed or PubMed Central (PMC), services from the U.S. National Institutes of Health's National Library of Medicine (NIH/NLM). Some of these articles may be available as full text directly in PMC. If not, check the top right corner for links to full text from the publisher's website, or search for the publisher website online to see if articles are published digitally. If full text is not available, contact your university / hospital / local librarian for information on how to obtain the full article.

Recycling/Waste

An audit of potentially recyclable waste from anaesthetic practice
From Anesthesia and Intensive Care.
The Gold in Garbage: Implementing a Waste Segregation and Recycling Initiative
From the Association of periOperative Registered Nurses Journal. Request full text via ILLiad.
An Initiative to Optimize Waste Streams in the Operating Room: RECycling in the Operating Room (RECOR) Project
From AANA Journal.
Intraoperative waste segregation initiative among anesthesia personnel to contain disposal costs
From Waste Management.
A national survey on attitudes and barriers on recycling and environmental sustainability efforts among Canadian anesthesiologists: An opportunity for knowledge translation
From the Canadian Journal of Anaesthesia.
Operating room waste: disposable supply utilization in neurosurgical procedures
From the Journal of Neurosurgery.
Preventable drug waste among anesthesia providers: Opportunities for efficiency
From the Journal of Clinical Anesthesia.
Propofol wastage in anesthesia
From Anesthesia and Analgesia.
Recycling glass and metal in the anaesthetic room
From Anaesthesia.
Recycling steel from single-use laryngoscope blades and Magill forceps
From Anaesthesia.
A survey of anesthesiologists' views of operating room recycling
From Anesthesia and Analgesia.

Anesthetic Gases

Assessing the impact on global climate from general anesthetic gases
From Anesthesia & Analgesia.
Brief review: theory and practice of minimal fresh gas flow anesthesia
From the Canadian Journal of Anaesthesia.
The climatisation of anesthetic gases under conditions of high flow to low flow
From Acta Anaesthesiologica Belgica.
Greenhouse gases: the choice of volatile anesthetic does matter
From the Canadian Journal of Anaesthesia.
Inhalation anaesthetics and climate change
From the British Journal of Anaesthesia.
Low-flow anaesthesia with a fixed fresh gas flow rate
From the Journal of Clinical Monitoring and Computing.
Low-flow anaesthesia – underused mode towards “sustainable anaesthesia”
From the Indian Journal of Anaesthesia.
Managing fresh gas flow to reduce environmental contamination
From Anesthesia & Analgesia.
Nitrous oxide in waste anesthetic gases with different fresh gas flow: a case-based pilot observation and a practical thought on scavenging
From Medical Gas Research.
Occupational exposure to volatile anaesthetics: a systematic review
From Occupational Medicine (Oxford, England).
Precautionary Practices for Administering Anesthetic Gases: A Survey of Physician Anesthesiologists, Nurse Anesthetists and Anesthesiologist Assistants
From the Journal of Occupational and Environmental Hygiene.
Re-defining the 3R's (reduce, refine, and replace) of sustainability to minimize the environmental impact of inhalational anesthetic agents
From the Canadian Journal of Anaesthesia.
Waste anesthetic gas exposure and strategies for solution
From the Journal of Anesthesia.

Finances/Cost

Environmental and financial impact of a hospital recycling program
From AANA Journal.
Financial and environmental costs of reusable and single-use anaesthetic equipment
From the British Journal of Anaesthesia.
The green operating room: simple changes to reduce cost and our carbon footprint
From The American Surgeon.

Other

Comparative life cycle assessment of disposable and reusable laryngeal mask airways
From Anesthesia and Analgesia.
Environment-friendly practices in operating rooms in Turkey
From The Journal of Nursing Research.
Environmental Externalities of Switching From Inhalational to Total Intravenous Anesthesia
From Anesthesia & Analgesia. Request full-text via ILLiad.
Environmentally sustainable perioperative medicine: Simple strategies for anesthetic practice
From the Canadian Journal of Anesthesia.
Environmental sustainability in anaesthesia and critical care
From the British Journal of Anaesthesia.
Environmental sustainability in hospitals - a systematic review and research agenda
From the Journal of Health Services Research and Policy.
Genotoxic effects of anesthetic agents: an update
From Expert Opinion on Drug Safety.
Greening healthcare at Muskoka Algonquin Healthcare
From Healthcare Management Forum.
Life cycle greenhouse gas emissions of anesthetic drugs
From Anesthesia & Analgesia.
Managing barriers to recycling in the operating room
From the American Journal of Surgery.
Performance of four carbon dioxide absorbents in experimental and clinical settings
From Anaesthesia.
Plastics and Environmental Health: The Road Ahead
From Reviews on Environmental Health.

Click the links to be redirected to the book chapters. The book with the cover picture is available in full electronically for CCSU students, faculty, and staff. Click the title link to be directed to the book's catalog record. Under "View It," use the EBSCOHost eBooks platform to access the book. The second book chapter is available through the U.S. Library of Medicine. Click the link to be redirected.

Anesthesia Equipment: Principles and Applications by Jan Ehrenwerth; James M. Berry; James B. Eisenkraft
Call Number: ONLINE
ISBN: 9780323170062
Publication Date: 2013-01-01
See section on waste anesthetic gases and scavenging systems (pages 125-147).

Waste Gas Scavenging System
This book chapter is available in the U.S. Library of Medicine's NCBI database.

These articles are not indexed in PubMed or PMC and require a subscription, login, or payment on publisher websites to view. You may be able to access these through your university, hospital, or local library subscription databases. Check with your librarian for more information on how to access these resources.

Wenger L. Greener ORs:keys to making the business case. OR Manager. 2012;28(5):1-4.

Ryan-Fogarty Y, O’Regan B, Moles R. Greening healthcare: systematic implementation of environmental programmers in a university teaching hospital. J Clean Prod. 2016;126:248-259.

Plisko JD, Flora C, Cusick C. Waste prevention and management in hospitals. Presented at: Solid Waste Technology and Management Meeting; March, 2015; Philadelphia, PA.

Wilson AJ, Nayak S. Disinfection, sterilization, and disposables. Anaesth Intensive Care Med. 2016;17(10):475-479. https://doi.org/10.1016/j.mpaic.2013.07.004.

Ang TN, et al. A techno-economic-societal assessment of recovery of waste volatile anaesthetics. Sep Purif Technol. 2019; 226:304-314.

Sherman JS, McGain F. Environmental sustainability in anaesthesia: Pollution prevention and patient safety. Adv Anesth. 2016;34:47-61. Doi:10.1016/j.aan.2016.07.004.

Vollmer M, Rhee T, Rigby M, et al. Modern inhalation anesthetics: potent greenhouse gases in the global atmosphere. Geophys Res Lett. 2015; 42: 1606–11.

Ang TN, Baroutian S, Young BR, et al. Adsorptive separation of volatile anaesthetics: A review of current developments. Sep Purif Technol. 2019;211:491-503. https://doi:10.1016/j.seppur.2018.10.012.

Green Anesthesia Podcasts and Media

Dr. Jodi Sherman speaks at the 2020 Clinical Climate Change Conference
GOR Energy Series: Effectively Managing Waste Anesthesia Gas
A pre-recorded presentation from Greenhealth Academy. There is a fee for non-members to view this presentation ($).
OpenAnesthesia Multimedia
Podcasts from OpenAnesthesia.org.
Promoting the Environmentally Conscious Practice of Anesthesia w. Dr. Timur Ozelsel
E13 of the podcast Anesthesia Success.