Work

A survey of nitrous oxide use, attitudes and environmental sustainability considerations by anaesthetists across metropolitan local health districts in New South Wales

Year: 2025

Type: article

Abstract: Nitrous oxide (N 2 O) is a potent greenhouse gas used to provide analgesia and anaesthesia in healthcare. Leaks from the manifold-pipeline systems may result in significant losses of N 2 O before delivery to the patient. The provision of N 2 O by cylinder at point-of-care is proposed as a leak-reducing alternative to manifold-pipeline systems. The primary endpoint of this study was to determine the percentage of anaesthetists who considered it acceptable for N 2 O to be supplied by cylinder rather than a manifold-pipeline system. It also explored the current application of N 2 O and prevailing attitudes toward its environmental impact and future role in anaesthetic practice. A cross-sectional survey was administered in 2023 among anaesthetists working across seven metropolitan hospitals in New South Wales, Australia. Participants provided self-reported information on demographics, practice characteristics, views on climate change, the role of anaesthetists in addressing environmental concerns, routine N 2 O usage, and the potential shift to cylinder supply of N 2 O. Among the 287 respondents, the majority ( n =241, 84.6%) were current users of N 2 O, although most administered it infrequently (71.5% used it in less than 25% of cases). Attitudes regarding N 2 O’s environmental impact varied irrespective of career stage. Notably, 219 of 287 (76.3%) favoured using cylinders over the manifold-pipeline network. These findings indicate a decreasing trend in N 2 O usage, especially among early career anaesthetists, and suggest that transitioning to cylinder supply is acceptable, provided that strategies are in place to manage supply disruptions without compromising patient care.

Source: Anaesthesia and Intensive Care

DOI: 10.1177/0310057x251396232

Authors: Henry CM Clutterbuck, Timothy J Marshall, Sascha Karunaratne, Daniel Steffens, Michael Paleologos, Charlotte Johnstone

Institutions: The University of Sydney, Royal Prince Alfred Hospital

Language: English

Topic: Anesthesia and Sedative Agents

Subfield: Anesthesiology and Pain Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $4,150