Central nitrous oxide pipeline shutdown linked to major emissions cut

A multicenter interrupted time-series study across 11 NYC Health + Hospitals facilities analyzed 148,762 general anesthetic cases to evaluate strategies for reducing anesthetic greenhouse gas emissions. The study found that central N2O pipeline deactivation was associated with the largest reduction in N2O-attributable hourly CO2e emissions, that a clinical decision support advisory produced a smaller but statistically significant reduction in fresh gas flow and total emissions, and that at one hospital 94.6% of centrally supplied N2O was lost before reaching patients, generating emissions 2.58 times greater than all clinically administered anesthetic gases combined across the system. The authors state these findings support the 2024 American Society of Anesthesiologists recommendation to deactivate centrally piped N2O.

Most relevant for: Anesthesia departments and health systems evaluating operating room strategies to reduce greenhouse gas emissions from anesthetic gas delivery.

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