Percentage of adult cases where nitrous oxide is avoided during anesthesia
Inhalational agents (halogenated hydrocarbons and nitrous oxide) leaking or vented into the atmosphere are environmental pollutants with significant global warming potential. 1-7
N2O is both a potent greenhouse gas and an ozone depleting agent. N2O has an atmospheric lifetime of 114 years, the longest of the commonly used inhaled agents. Thus, the use of N2O as a carrier gas compared to air/oxygen substantially increases the global warming impact in the operating room.
Eliminating the use of nitrous oxide in the operating room can decrease occupational exposure, public health harm, and cost of anesthesia without compromising patient care.
Agent |
Global Warming Potential100 |
Atmospheric Lifetime (years) |
Molecular Weight (g/mol) |
Isoflurane4 |
565 |
3.2 |
184.5 |
Sevoflurane3 |
144 |
1.1 |
200 |
Desflurane4 |
2720 |
14 |
169 |
Nitrous Oxide5 |
282* |
114 |
44 |
Table adapted from American Society of Anesthesiologists’ Task Force on Environmental Sustainability Committee on Equipment and Facilities: Greening the Operating Room and Perioperative Arena: Environmental Sustainability for Anesthesia Practice2
*Nitrous oxide value is derived as an average of the range provided on the EPA website: 265-298.
Adult patients undergoing any procedure requiring anesthesia.
Age <18 years
Nitrous oxide was not administered during Anesthesia Start to Anesthesia End
Values for flows and inhalational agents will be assessed and considered as artifact if inside the following ranges:
*This measure will include valid MPOG cases defined by the Is Valid Case phenotype.
Not applicable
Provider(s) signed in when nitrous oxide was administered
Measure Author |
Institution |
Henrietta Addo, MSN, RN |
University of Michigan |
Nirav Shah, MD |
Unviersity of Michigan |
Rob Coleman |
University of Michgan |
Date Reviewed | Reviewer | Institution | Summary | QC Vote |
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N/A |
N/A |
N/A |
N/A |
N/A |
Date | Criteria | Revision |
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