Reduction in anesthesia-related nitrous oxide consumption and environmental footprint via a quality improvement initiative at two quaternary hospitals in São Paulo, Brazil
Authors' conclusion
By optimizing N2O usage through educational and judicious interventions, our QI initiative achieved a 82.5% postintervention reduction in anesthesia-related institutional CO2e.
Study context
- Population
- Anesthetics at two quaternary hospitals in São Paulo, Brazil, January to August 2024anesthetics over 32 weeks
- Participants
- 30,217 participants
- Comparison
- Post-intervention vs pre-intervention
- Outcome
- N2O usage and carbon footprint (CO2e); target 75% reduction
- Follow-up
- 16 weeks
Methodological detailsbefore-after, two-centre
- Before-after
- Two-centre
Main finding
As reported in the abstract
N2O usage rate, adults
P < 0.001
Further findings
Nitrous oxide (N2O) usage rate (pediatric patients)
- In pediatric patients, N2O usage dropped from 62% to 46% following the intervention
- P < 0.001
Emissions per anesthetic using N2O
- Emissions per anesthetic using N2O declined from 132 kg (LCL 98 kg; UCL 167 kg) to 23 kg (LCL 9 kg; UCL 38 kg) following the interventions
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Reduction in anesthesia-related nitrous oxide consumption and environmental footprint via a quality improvement initiative at two quaternary hospitals in São Paulo, Brazil. Can J Anaesth. Published 7 July 2025. doi:10.
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