Should pipeline nitrous oxide be discontinued in secondary care: A cost-benefit analysis

Background: Nitrous oxide (N 2 O) has seen a marked decline in its usage in recent years due to its adverse clinical effects. We audited the practice in our department to evaluate the N 2 O consumption and cost-effectiveness of its supply. Methodology: Electronic anesthesia records of all patients anesthetized in our main operating rooms in a typical month were reviewed retrospectively, and utilization of N 2 O was noted in addition to the patient demographics, surgical procedure, and specialty. Results: A total of 950 patients were anesthetized, and 3.1% received N 2 O. The annual usage was estimated to be 72,871 liters, with a leakage of 3,883,105 liters to the environment, posing a safety hazard and wasting 149,612.50 SAR. Conclusion: Notable costs and environmental benefits may be achieved by substituting a piped supply of N 2 O with portable E-cylinders on demand in operating rooms for rational use.