Sustainability in veterinary anaesthesia


In 2010, The Lancet called climate change “potentially the biggest global health threat of the 21st century” (Costello et al. 2009). It has been widely understood that climate change will have significant adverse effects on global health. What is now becoming clear is the contribution of healthcare systems in causing climate change, and this includes the practice of veterinary anaesthesia. It is essential that veterinary anaesthetists also commit to reducing our impacts on global health.


Sustainable development has been defined by the UN Brundtland Commission as “development that meets the needs of the present without compromising the ability of future generations to meet their own needs”. A recent review published in Veterinary Anaesthesia and Analgesia by Jones & West (2019) provides further detail on sustainable options in veterinary anaesthesia. The role of veterinary anaesthetists is likely to include:


  • Informing ourselves about the basic science of climate change, the likely impacts, and the urgent need to take action
  • Educating our wider community about the disproportionately potent greenhouse gas effects of inhalational anaesthetic agents, due to their action in ‘plugging’ the atmospheric window by which the planet cools itself (see Table 1)

Table 1: The atmospheric characteristics of anaesthetic gases and vapours (reproduced with permission from Jones & West (2019) Environmental sustainability in veterinary anaesthesia. Vet Anaesth Analg 46, 409-420).
Atmospheric characteristicsNitrous oxideDesfluraneIsofluraneSevofluraneCarbon dioxide
Atmospheric lifetime (years)110143.21.174
Radiative efficiency (W m-2 ppb-1)0.0030.4690.4530.3510.676
Global warming potential over 100 years31025405101301
  • Supporting anaesthesia providers in minimising inhalational anaesthetic gas use during anaesthesia, including using the lowest safe fresh gas flows, rebreathing systems and appropriate monitoring
  • Including sustainability principles into undergraduate and postgraduate curricula


  • Discussing reducing, or eliminating, the use of nitrous oxide in clinical veterinary practice due to its potent greenhouse gas effect and ozone depleting effects, and desflurane due to its potent greenhouse gas effects
  • Promoting sustainable conferencing
  • Following ethical procurement guidelines (BMA 2017 SDU – Ethical Procurement for Health: Workbook)
  • Incorporating sustainability principles into our own decisions regarding procurement, equipment use, waste management, energy and resource use (see Table 2)

Table 2: An anaesthesia sustainability checklist (reproduced with permission from Jones & West (2019) Environmental sustainability in veterinary anaesthesia. Vet Anaesth Analg 46, 409-420.
Reduce volatile anaesthetic atmospheric wasteLow fresh gas flow
Monitoring of inspired oxygen and end-tidal anaesthetic agent concentrations
Avoid high impact agents (desflurane, nitrous oxide)
Consider intravenous and regional techniques
Invest in waste anaesthetic recycling or destruction
Reduce pharmaceutical wasteUse prefilled syringes or pre-packed kits
Use appropriate sized vials
Dispose of pharmaceuticals appropriately
Replace perioperative injectable with oral medications
Reduce equipment wasteOnly open equipment intended for immediate use
Purchase reusable or reprocessed equipment
Adjust stock levels to minimise discard beyond expiry dates eliminate unnecessary items
Waste segregationEvaluate waste handling to move up the waste hierarchy
Segregate waste strictly, according to legal frameworks
Recycle where possible, in clinical and non-clinical streams
Use reusable or non-plastic waste containers
Minimise packaging
TextilesUse reusable textiles
Use towels and blankets efficiently
ElectronicsDo not use unless proven benefit
Use certified recycling site for disposal
LeadershipDevelop a sustainability plan and committee, with advocates at local level
Procure sustainably where possible
Promote staff engagement with sustainability
Evaluate travel within your organisation
Promote research into sustainability


  • Life cycle analysis (cradle-to-grave carbon emissions) for alternative systems e.g. intravenous anaesthesia for maintenance of anaesthesia, or anaesthetic gas reclamation techniques
  • Incorporating guidelines to reduce carbon emissions in research e.g. NIHR Carbon Reduction Guidelines


The UN has produced Sustainable Development Goals, and it is imperative that organisations align themselves with these goals. Specifically, the AVA has taken the following actions:

  • The majority of committee meetings are held electronically
  • We are supporting migration of membership from paper to electronic journals
  • We encourage sustainable conferencing at our biannual conferences, including plans for recording of conference streams
  • Our investments are consistent with our aim to be a socially and environmentally responsible organisation
  • We are developing a sustainability strategy which will be reviewed every 2 years, and a nominated committee member will retain responsibility for this strategy


Published papers

The Lancet Planetary Health is a gold Open Access journal that aims to establish and grow an entirely new field of scientific inquiry—namely, to investigate and provide solutions to the political, economic, social, and environmental determinants of healthy human civilisations and the natural systems on which they depend.

Sustainable healthcare organisations

National Healthcare Associations

Document developed by Ellie West CertVA DipECVAA AIEMA MRCVS
Sustainability Lead and Veterinary Anaesthetist

Last edit: Feb 2020