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Editorial
. 2025 Jun;134(6):1606-1609.
doi: 10.1016/j.bja.2025.03.005. Epub 2025 Apr 17.

The optimal mode of anaesthesia: are we ready for an evidence-based recommendation?

Jasper M Kampman  1 , Nicolaas H Sperna Weiland  2
Affiliations
Editorial

The optimal mode of anaesthesia: are we ready for an evidence-based recommendation?

Jasper M Kampman et al. Br J Anaesth. 2025 Jun.

Abstract

An environmental impact study compared the carbon footprint of three large French hospitals, one that used >99% total intravenous anaesthesia, one that used target-controlled inhalation anaesthesia, and one that used manually optimised fresh gas flow. We consider these results with previously published environmental impact analyses to determine which mode of anaesthesia is most environmentally friendly. Current understanding in the field following the triple bottom line of 'patient, planet, profit' informs an evidence-based recommendation around the optimal default mode of anaesthesia.

Keywords: carbon footprint; environment; inhaled anaesthetics; sustainability; total intravenous anaesthesia; volatile anaesthetics.

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Conflict of interest statement

Declarations of interest NSW and JK are chair and member, respectively, of the Sustainability Taskforce of the Dutch Society for Anaesthesiology (NVA). NSW chairs the Sustainability Committee of the European Society of Anaesthesiology and Intensive Care (ESAIC). JK was previously supported by a NVA Sustainability Grant (2023) for research on the use of TIVA and inhalation anaesthesia in the Netherlands.

Comment on

References

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