Carbon footprint of anaesthesia pharmaceuticals and disposable products during Caesarean delivery: a single-centre prospective observational study

Background

The healthcare sector, particularly surgical care, is a major contributor to greenhouse gas emissions. This study aimed to investigate the carbon footprint of anaesthesia during Caesarean delivery, considering the impact of disposable products and pharmaceuticals, to identify environmental hotspots.

Methods

A prospective observational study was conducted in a Dutch tertiary hospital, based on 50 Caesarean deliveries between July and October 2025. The carbon footprint of anaesthesia pharmaceuticals and disposable products was calculated using estimated kilograms of carbon dioxide equivalents (kg CO2-eq) from life-cycle assessment data and for pharmaceuticals using active pharmaceutical ingredients from life-cycle inventory data.

Results

The mean carbon footprint of anaesthesia pharmaceuticals and disposable products was 5.6 kg CO2-eq per Caesarean delivery. Disposables accounted for 80% (4.5 kg CO2-eq) of the total footprint. The prepackaged neuraxial tray, syringes, and warming blanket were the largest contributors, and ∼4% of the impact stemmed from unused disposable products. Pharmaceuticals contributed 1.1 kg CO2-eq, with i.v. fluids, cefazolin, and i.v. paracetamol being the highest.

Conclusions

Disposable products were the main contributor to the carbon footprint of anaesthesia during Caesarean delivery. Addressing unnecessary use of disposable products is an achievable goal for reducing emissions. In addition, minimising wasted pharmaceuticals or unused disposable products is important, given that they significantly amplify the carbon footprint without providing clinical benefit.