NET-ZERO ANESTHESIA: A STRATEGY FOR MITIGATION AND ENVIRONMENTAL SUSTAINABILITY

Abstract

The healthcare sector faces an ethical paradox by contributing significantly to the climate crisis, ranking as the fifth-largest global carbon emitter if it were a nation. In the hospital setting, the operating room stands out for its high environmental impact, with anesthetic practices accounting for a significant portion of greenhouse gas emissions and waste generation. This study discusses the environmental impacts related to anesthetic practice in the operating room, as well as sustainable alternatives and strategies that contribute to damage reduction. This is an integrative review of the literature (2020–2026) conducted in the PubMed, Scielo, Science Direct, and Google Scholar databases. The data were evaluated through a narrative synthesis, using inclusion and exclusion criteria, and categorizing the evidence into thematic areas. A total of 19 texts were read in full, resulting in the final selection of 6 studies for the theoretical framework and 13 for the results and discussion. It was found that inhalation anesthetics, such as desflurane, have a high Global Warming Potential, while the use of low-flow techniques, sevoflurane, or total intravenous anesthesia drastically reduce the carbon footprint. As for the waste generated by these methodologies, up to 90% is recyclable; however, inadequate segregation remains a cultural and operational barrier. Therefore, the strategy with the greatest immediate impact is the replacement of desflurane and the reduction of gas flow. Consequently, carbon neutrality or net-zero in anesthesiology requires the refinement of methodological practices, combined with the adoption of the “5 Rs” philosophy (Reduce, Reuse, Recycle, Rethink, and Research). Thus, professional awareness and a shift in institutional paradigms are urgently needed to ensure that current care does not compromise the health of future generations.