Anesthesiology team to 'Green the OR’ with carbon-neutral operating rooms

Anesthetic gases account for 30% to 50% of all hospital emissions

April 18, 2023
uci health anesthesiologist rakhi dayal leads a procedure in room with team members wearing scrubs and masks
UCI Health anesthesiologist Rakhi Dayal, left, is chair of the Department
of Anesthesiology & Perioperative Care's Conservation and Sustainability
committee. (Credit: Steve Zylius/UCI)

Irvine, Calif. - One of the largest university health network-based sustainability projects in the nation is taking place as five University of California medical centers work together to achieve carbon neutrality.

At UCI Health, one big change is happening in the operating room.

“Greening the OR”— an initiative to reduce operating room emissions — is an integral part of the UCI Health environmental commitment. The project is led by the UCI School of Medicine Department of Anesthesiology & Perioperative Care.

“About 30 to 50% of all hospital emissions each day come from the operating room,” said anesthesiologist Dr. Aalap Shah, , a member of the University of California (UC) Perioperative Conservation and Sustainability committee. “This is a big push.”

Reducing the use of anesthetic gases is part of a larger goal: “We are trying to build toward carbon neutrality."

Highlights of the “Greening the OR” initiative include:

  • Recipient of the Greenhealth Emerald Award in July 2022, which highlighted several UCI Health projects, including decreasing anesthetic use
  • A 25% decrease in greenhouse gas emissions at UCI related to anesthetic use since the project was initiated in 2022
  • Several publications resulting from this project, including one about the technical innovation created and vetted by the UCs' centers. Another article documents the challenges in attaining reducing anesthetic gas use within academic hospital systems

The team is working with its colleagues at UC San Diego on the launch of its own greenhouse gas initiative program.

“Think about all of this gas that we breathe in and out every single day, hundreds of procedures across UCI,” Shah said.

“We put together a clinical decision-support system and educational package that helps our department and others in the UC system to significantly decrease the amount of anesthetics we give, decreasing both cost and our carbon footprint.”

“I think we have significant room to improve more, but the fact that we have been doing this and we have sustained results that have been there for almost a year now is pretty significant.”

The UCI team is also working with colleagues at UC San Diego Health to launch their greenhouse gas initiative program.

Other outcomes of the committee’s project include:

  • Sustaining a 25% decrease in anesthetic emissions in UCI Health operating rooms over 1 1/2 years, based on analysis of data from 22,000 surgical cases
  • A decrease in CO2 emissions equivalent to driving a car 54,000 miles over 1 1/2 years
  • A projected economic savings of $15,000 per year at UCI Health alone

Future goals include:

  • Further reducing the use of inhalational gases as an effective strategy for a net-zero healthcare system
  • Continue the UC-wide reporting on effective implementation of the inhaled gas reduction initiative
  • Providing extensive information and scientific literature to enable similar changes in sustainable clinical practices nationwide

“I think this clearly shows how dedicated we are to this very important project and associated initiatives,” said UCI Health anesthesiologist and committee chair Dr. Rakhi Dayal. “We have dedicated a tremendous amount of time and effort to this very worthy purpose.”

Both leaders emphasized the need for global participation from all aspects of UCI Health to facilitate and sustain the results achieved.

“It’s easy to make a change, but it’s not so easy to sustain the change. People move to other companies, priorities might change, things happen. You can’t rely on people; you have to change the culture. That’s one of the biggest things in sustainability.”

UCI Health is the clinical enterprise of the University of California, Irvine, and the only academic health system in Orange County. Patients can access UCI Health at primary and specialty care offices across Orange County and at its main campus, UCI Medical Center in Orange, Calif. The 459-bed acute care hospital, listed among America’s Best Hospitals by U.S. News & World Report for 22 consecutive years, provides tertiary and quaternary care, ambulatory and specialty medical clinics, behavioral health and rehabilitation services. UCI Medical Center is home to Orange County’s only National Cancer Institute-designated comprehensive cancer center, high-risk perinatal/neonatal program and American College of Surgeons-verified Level I adult and Level II pediatric trauma center and regional burn center. UCI Health serves a region of nearly 4 million people in Orange County, western Riverside County and southeast Los Angeles County. Follow us on Facebook, Instagram, LinkedIn and Twitter.