Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Sep:40:100518.
doi: 10.1016/j.pcorm.2025.100518. Epub 2025 Jun 28.

Association between Reusable Anesthesia Circuits and Hospital Waste Reduction, Cost Savings, and Environmental Impact: A Quality Improvement Study

Aurora Quaye  1   2   3 , Charm Karunasiri  1 , Janelle Richard  1 , Michael Arsnow  4 , Robert Montague  1 , Wendy Craig  3   5 , Alysse G Wurcel  6   7
Affiliations

Association between Reusable Anesthesia Circuits and Hospital Waste Reduction, Cost Savings, and Environmental Impact: A Quality Improvement Study

Aurora Quaye et al. Perioper Care Oper Room Manag. 2025 Sep.

Abstract

Background: Anesthesia services are a major contributor to healthcare sector greenhouse gas emissions. Interventions aimed to reduce waste are necessary. Reusable anesthesia circuits offer a sustainable alternative to single-use circuits. Their adoption in the United States remains limited. The objective of this project was to evaluate the feasibility, cost-effectiveness, and environmental impact of using FDA-approved reusable anesthesia circuits.

Methods: Supported by the SMART QI framework, we evaluated the impact of switching to reusable circuits on elective electroconvulsive therapy (ECT) procedures. We measured waste generation, room preparation times, material costs, and projected system wide financial and greenhouse gas emissions impact. Greenhouse gas emissions were estimated using the Practice Greenhealth Scope 3 Emissions Accounting Tool. Descriptive statistics compared pre- and post-intervention outcomes, with statistical significance at p < 0.05.

Results: We compared 185 ECT procedures: 98 single-use from pre-intervention and 87 reusable circuits from post-intervention. Preparation times did not change. Daily waste from reusable circuits was significantly lower than single-use circuits (99.2g vs. 357.2g, p < 0.001). Cost analysis revealed 40% reduction in median per-case expenditures with reusable circuits ($4.30 vs. $8.50 per patient, p < 0.001).Scope 3 greenhouse gas emissions per procedure decreased nearly 50% (1.09 kgCO2 vs. 2.57 kgCO2, p < 0.001). Modeling of institutional-level data projected an annual cost savings of $108,860 and a reduction of 45,062.4 kgCO2 if reusable circuits were implemented across all hospitals in the network.

Discussion: Reusable anesthesia circuits can significantly reduce hospital waste, lower costs, and decrease carbon emissions without compromising procedural efficiency.

Keywords: Anesthesia; costbenefit analysis; environment; feasibility studies; greenhouse gases; sustainability.

PubMed Disclaimer

Conflict of interest statement

Declaration of interests The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Wendy Y. Craig reports financial support was provided by National Institutes of Health. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Similar articles

See all similar articles

References

    1. Freifeld AG, Todd AI, Khan AS. The climate crisis and healthcare: What do infection prevention and stewardship professionals need to know? Antimicrob Steward Healthc Epidemiol. 2023;3:e136. 10.1017/ash.2023.170 - DOI - PMC - PubMed
    1. American Medical Association. U.S. health system must come to terms with its environmental impact. 2022. [updated 10/11/2022]. Available from: https://www.ama-assn.org/delivering-care/public-health/us-health-system-...
    1. Zhao B, Rehati P, Yang Z, Cai Z, Guo C, Li Y. The potential toxicity of microplastics on human health. Sci Total Environ. 2024;912:168946. 10.1016/j.scitotenv.2023.168946 - DOI - PubMed
    1. Babu MA, Dalenberg AK, Goodsell G, Holloway AB, Belau MM, Link MJ. Greening the Operating Room: Results of a Scalable Initiative to Reduce Waste and Recover Supply Costs. Neurosurgery. 2019;85:432–7. 10.1093/neuros/nyy275 - DOI - PubMed
    1. Gasciauskaite G, Lunkiewicz J, Spahn DR, Von Deschwanden C, Nöthiger CB, Tscholl DW. Environmental sustainability from anesthesia providers’ perspective: a qualitative study. BMC Anesthesiol. 2023;23:377. 10.1186/s12871-023-02344-1 - DOI - PMC - PubMed

LinkOut - more resources