Carbon Footprint of General, Regional, and Combined Anaesthesia for Total Knee Replacements

Rosie Hillson's picture


Resource Description: 

'Health care itself contributes to climate change. Anesthesia is a “carbon hotspot,” yet few data exist to compare anesthetic choices. The authors examined the carbon dioxide equivalent emissions associated with general anesthesia, spinal anesthesia, and combined (general and spinal anesthesia) during a total knee replacement.'

Forbes McGain, Nicole Sheridan, Kasun Wickramarachchi, Simon Yates, Brandon Chan, Scott McAlister; Carbon Footprint of General, Regional, and Combined Anesthesia for Total Knee Replacements. Anesthesiology 2021; 135:976–991 doi:

Article along with an article podcast.



Publication date: 

December, 2021

Resource type: 

  • case study


STUDY of RA carbon footprint

Jasmine Winter Beatty's picture

Has anyone else read this article and found it rather dubious?

I struggle with the methodology and the results. A part from the huge amunt of oxygen being used in RA with sedation, what anaesthetic equipement are they using an extra 4.03 kgCO2e to wash & sterilise? it cant be only the gown surely (in Vozzola's paper reusable gowns have a GWp of 0.557 kgco2e vs disposable 1.636 kgCo2e)? could it be a spinal pack of some sort?

If you had any suggestions to help me understand, I would be glad to hear them!

Thank you


Study of RA carbon footprint

Emma Evans's picture

The authors acknowledge that its the electricity involved in powering heating, scavenging, powering sterilisers and ventilation during the longer RA procedures - i assume while they wait for the block to take effect as sole anaesthesia - that has a much bigger impact as Australia than the UK equivalent would. AMD yes turning down those O2 flows would really help!

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