Implementation of a quality improvement project at National University Hospital Singapore to mitigate the environmental impact of nitrous oxide
Authors' conclusion
This quality improvement project shows that substantial reduction in N2O systemic consumption in an OR complex is possible through changing the N2O supply from a central piped supply system to small cylinders directly mounted on anesthesia machines.
Study context
- Population
- OR complex, National University Hospital Singapore
- Comparison
- Portable cylinder nitrous oxide (N2O) supply in ORs vs central piped supply system
- Outcome
- N2O systemic consumption (estimated using monthly procurement data)
Methodological detailsthree sequential Plan-Do-Study-Act cycles, single-centre
- Three sequential Plan-Do-Study-Act cycles
- Single-centre
Main finding
As reported in the abstract
N2O systemic consumption
Reduction in N2O systemic consumption (monthly procurement data)
96%
Further findings
GA cases using N2O (snapshot audits)
- Reduction in number of GA cases using N2O
- 66%
Annual carbon and financial savings (projected)
- Annual carbon savings, tonnes CO2e
- 307
- Annual financial savings, CAD
- 7,620
Original publication
Implementation of a quality improvement project at National University Hospital Singapore to mitigate the environmental impact of nitrous oxide. Can J Anaesth. Published 30 June 2025. doi:10.
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