Health care itself contributes to climate change. Anesthesia is a “carbon hotspot,” yet few data exist to compare anesthetic choices. In this issue of Anesthesiology, McGain et al. examined the carbon dioxide equivalent emissions associated with general anesthesia, spinal anesthesia, and combined (general and spinal anesthesia) during a total knee replacement. In an accompanying editorial, Struys and Eckelman discuss how practicing anesthesiologists can lower the environmental footprint of anesthesia. Cover Design: A. Johnson, Vivo Visuals Studio. Cover Image: “This is the waste of one operation… my operation” by Dutch spacial artist Maria Koijck, created with waste generated during her own surgery. Cover Photograph: Eva Glasbeek, published with permission from the artist.

  • McGain et al.: Carbon Footprint of General, Regional, and Combined Anesthesia for Total Knee Replacements, p. 976

  • Struys and Eckelman: Environmental Footprint of Anesthesia: More than Inhaled Anesthetics! p. 937