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Maintaining Anesthesia Sustainability During Bronchoscopies

Sustainability in the OR – eNewsletter

ISSUE 6 – 2023

Sustainability Matters - How and why you should make the effort in your ORs

Anesthesia Sustainability During Bronchoscopies


Many of us provide general anesthesia for complex bronchoscopy procedures of varying durations. Due to frequent suctioning and other leaks, keeping the ventilator bellows full can be quite a task and usually requires high flows. Did you know that using volatile agent for these cases is not only counter to providing a sustainable anesthetic but also extremely wasteful and expensive?

  • This practice can result in 4 – 6 liters, or more, of volatile agent-containing waste gas flowing out from our rooftop every single minute of the case.
  • Given that some of the more complex interventional cases can have durations of over an hour, the environmental impact can be considerable.

Provide Total IntraVenous Anesthesia (TIVA)
for all bronchoscopy procedures.

Think about it… We provide TIVA frequently for spine cases with neuromonitoring; we provide it for malignant hyperthermia patients; we provide it for patients with severe PONV history.

The large amount of waste gas produced from high fresh gas flows during bronchoscopies is yet another important reason to use TIVA.

Today’s takeaway

In the interest of sustainability, waste reduction, and cost savings,
please deliver TIVA for all bronchoscopies.

Next time in Sustainability in the OR:
“Reviewing the Key Points of 2023”
Until then, be well. Adam

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As has been said by many individuals in various ways:
“We did not inherit this earth; we are borrowing it from our children.”
Do you have a success story you would like to share? Please use the contact information below to get in touch. I’d love to hear from you.

Learn more

APSF low-flow anesthesia education

Become a low-flow anesthesia expert and earn CME’s!
Complete this hands-on low-flow anesthesia education learning module (if you haven’t done so already).  Earn CMEs through

Low-Flow Anesthesia – Anesthesia Patient Safety Foundation
This APSF module will greatly assist you in becoming much more comfortable with the concepts of safe delivery of low-flow anesthesia. Low-flow anesthesia maintenance is the single best clinical practice for us to make the most of our contribution toward protecting our planet.

If you haven’t done so already, please consider completing this activity and gradually apply what you have learned to your practice.

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Maintaining Anesthesia Sustainability During Bronchoscopies