Committee on Environmental Health Releases New Edition of ‘Greening the Operating Room and Perioperative Arena’

The ASA document is intended to offer guidance to anesthesiologists in these activities. Environmental Emissions Reporting and Life Cycle AssessmentKey points • Life cycle assessment is an internationally standardized scientific method (ISO 14040 and 14044) of quantifying emissions from the material and energy inputs associated with products and processes.• While global warming potential (carbon dioxide equivalents, CO 2 e) is the most well-known type of emission studied and reported, several standard categories of environmental impacts are routinely evaluated.• Life cycle assessment is frequently coupled with life cycle costing to combine both environmental impact and organizational financial cost considerations to aid decision-making.3. Anesthesia Equipment and Supplies Key points • Equipment choices must take environmental considerations and supply chain resilience into account.• Life cycle emissions and costs associated with single-use disposable and reusable equipment tend to favor reusable equipment.• Reprocessing single-use disposable devices is strictly regulated by the Food and Drug Administration (FDA) to ensure patient safety and can potentially save costs and emissions compared to wasting devices after single use.• Procedure kits should be reformulated and streamlined to eliminate waste.• Care must be taken to avoid premature equipment upgrades that are both costly to organizations and environmentally harmful.• Purchasing agreements can be negotiated to include taking back old equipment for refurbishing and donation, repurposing of parts, or recycling by a third-party verified green vendor.4. The Environmental Impact of Inhaled Anesthetics Key points • Volatile anesthetics and nitrous oxide (N 2 O) are potent greenhouse gases.N 2 O also contributes to depletion of the ozone layer.• Desflurane is the inhaled anesthetic that is the most potent greenhouse gas, with a global warming potential (GWP 100 ) of 2,540, followed by isoflurane (539), nitrous oxide (273), and sevoflurane