Carbon footprint, sustainability and anesthesia. We are beginning to learn

Human health has been negatively impacted by the difficult environmental conditions produced by climate change. The health industry, paradoxically, generates a carbon footprint (CF) that drives climate change and represents 9.8% of the greenhouse gas (GHG) emissions in the United States (2013) and 6.3% of CF in England (2017). A considerable portion of these emissions comes from the clinical practice of anesthesia. Anesthetic gases present global warming potentials (GWPs) of up to 3,714 times higher than CO 2 throughout their life cycles, from their manufacture and use to their disposal. In this context, this review compiled and assessed the environmental impacts of the anesthetic strategy in clinical practice, making use of the life cycle analysis tool. This review describes how the anesthetic technique has a major impact on CF, through the emission of GHG expressed through tools such as the GWP 100 . As an example, at the manufacturing stage, the GWP of halogenated gases is up to 2,540 kg CO 2 eq versus 21 kg CO 2 eq for Propofol. This and other variables determine the contribution of the anesthetic technique in the emission of GHG. Finally, this review aims to help health care providers make informed decisions when considering the CH and sustainability of each anesthetic technique.