Table 1.

Current global practice regarding environmental-impact reduction in operating theatres, organized by scope of the greenhouse gas protocol¹³

	Overall	HIC	LMIC
Scope 1
Reducing desflurane use	25.3	31.1	18.6
Removing desflurane from theatre	18.8	19.7	17.9
Reducing nitrous oxide use	32.4	33.4	31.3
Removing nitrous oxide from theatre	23.6	20.8	26.3
Using low flow when using volatile anaesthetics	39.4	40.5	38.2
Mandating total intravenous anaesthesia	13.9	12.1	16.0
Scope 2
Turning off lights in theatre at night/weekends	61.1	60.6	61.9
Motion-activated lights	14.8	14.3	15.7
Turning down heating/air conditioning at night/weekends	40.5	31.5	52.0
Installing light-emitting diode (LED) lights	31.5	26.1	38.6
Switching off taps between hand washing	64.1	62.4	66.7
Scope 3
Recycling non-contaminated waste	34.0	38.0	27.5
Reducing plastic syringe use	13.2	12.7	13.9
Reducing unnecessary intravenous fluid use	35.4	30.7	42.1
Reducing unnecessary intravenous drug use	37.3	32.0	44.5
Using reusable surgical gowns	23.3	14.8	36.9
Using reusable surgical drapes	23.1	14.2	37.5
Reducing single-use instruments	23.1	15.7	34.6
Switching blue sterile tray wraps to metal canister trays	23.4	18.4	31.6
Redesigning trays for efficiency	19.4	16.4	24.0
Reducing disposable glove use for simple patient transfers	16.5	11.0	24.9
Using reusable laparoscopy ports	26.8	13.7	45.2
Reserving laparoscopic and robotic surgery	37.0	33.6	42.1
Using reduced packaging	22.7	17.0	30.2

Values are percentages. Scope 1, direct emissions; scope 2, emissions from electricity; and scope 3, all other indirect emissions from the supply chain.¹³ HIC, high-income country; LMIC, low–middle-income country.