The climate crisis has been named the world's biggest health threat by the United Nations. Greenhouse gases are a cause, and, unfortunately, greenhouse gas emissions from U.S. health care have increased by more than 30% over the last decade (Nature 2020;586:248-56). U.S. health care greenhouse gas emissions account for around 8.5% of national greenhouse gas emissions and would rank 13th in the world – ahead of the entire United Kingdom – if the U.S. health care system was a country (Health Aff 2020;39:2071-9; asamonitor.pub/3KofI4c). Inhalational anesthetics account for 50% of perioperative emissions in high-income countries (Anaesthesia 2022;77:1023-9).

Various anesthetic agents have been compared to carbon dioxide's global warming potential over a 100-year period (GWP100), where the larger the number, the higher the heat-trapping impact. The GWP100 for nitrous oxide (N2O) is 273, which means its global warming potential is 273 times...

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