Anaesthetic Gases & Metered Dose Inhalers

Medical devices

Entonox, anaesthetic gases and metered dose inhalers all have extremely high carbon equivalent factors. This means that a small amount of a medical gas (e.g. desflurane) has the same impact as a huge quantity of carbon dioxide.

In 2024/25, our use of Nitrous Oxide and Entonox alone emitted the equivalent of 1,226 tonnes of CO2e.

Changing which anaesthetic gas we use, adopting new low-flow anaesthetic machines, and using total intravenous anaesthesia can all have an impact. We can also use gas scavenging systems to capture and break down these harmful gases.

Metered Dose Inhalers (MDIs) use a hydrofluorocarbon propellant, which is then released into the atmosphere as the medicine is delivered. Dry powder inhalers have a lower carbon impact, but cannot be used in very young children.

These areas show the complex decisions and clinical innovation that is needed to make NHS care 'climate safe'.

What we've done:

  • Introduced our Inhaler Recycling Scheme at the Children’s Hospital.
  • Begun investigated technologies to destroy Nitrous Oxide after patient use.
  • Complete an audit on the type of inhalers recycled in the first full inhaler box to understand CO2e saving.

What we're doing

  • Focused on decommissioning the N20 manifold at BW and BC.
  • Work is planned to assess the indicated quantity of a retro-fitted N2O cylinder based on certain flow rates.  
  • Exploring how we make sure children are on the right inhalers.