The U.S. health care sector is a major contributor to environmental degradation. The effects are several-fold, and many are addressed elsewhere in this issue of the Monitor. The authors, here, will focus on the impact of nitrous oxide in anesthetic practice on planetary health

Since its introduction in the 1840s, nitrous oxide has remained a common inhaled sedative and adjunct to general anesthesia. Lack of pungency, fast-on/fast-off pharmacokinetics, anxiolytic and analgesic properties, and maintenance of a more stable hemodynamic profile when compared to volatile anesthetics alone have made it a favorite among many practitioners. There are several known contraindications to its use (closed air spaces, etc.), but this article will dwell on lesser-known environmental and health impacts: potential contribution to greenhouse gas emissions, degradation of the ozone layer, and untoward effects on patients and exposed healthcare workers....

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