Modern anesthetic agents are known greenhouse gases with hundreds to thousands of times the global warming impact compared to carbon dioxide (CO2). Less than 5% of halogenated anesthetic gases are metabolized by the body, and the remainder is removed by OR waste gas scavenging systems that pump the gas virtually unchanged into the atmosphere. Desflurane and nitrous oxide are common anesthetic volatile agents with particularly harmful environmental impacts. Desflurane has a notably high global warming potential (GWP), which is a measure of the infrared radiation absorbed by a greenhouse gas over a period of time expressed relative to CO2. While the 100-year GWP (GWP100) of CO2 is equal to 1 by definition, the GWP100 of sevoflurane, desflurane, and nitrous oxide are 130, 2540, and 298 respectively, and these gases have an atmospheric lifespan of 1.1, 14, and 114 years respectively. Nitrous oxide additionally directly depletes the ozone layer, which protects the Earth from harmful UV-B radiation from the sun.

The climate impact of an anesthetic gas also depends on the amount of gas required to provide adequate anesthesia. This measure is determined by the potency of the gas, the minimum alveolar concentration (MAC), and the fresh gas flow (FGF) at which the gas can be used. The greenhouse gas effect of an anesthetic gas, taking into account GWP and amount of gas used, is commonly expressed as carbon dioxide equivalent (CDE). When used at a FGF of 1 L/min at 1 MAC-hour, the 100-year CDE of desflurane is fifty times greater than that of sevoflurane. Minimizing the use of desflurane is thus an important strategy for decreasing anesthetic emissions. Indeed, a study of three hospitals in Canada, the UK, and the US found that anesthetic agents were the greatest source of OR gas emissions in hospitals where desflurane was routinely used.

In addition to environmental benefits, sevoflurane is often cheaper. Reducing desflurane has been associated with savings of as much as $25,000 USD per month, as reported at the University of Wisconsin.

Given the harms of desflurane, some Canadian institutions, including in London, Vancouver, and Toronto have begun to phase down its use, while other systems such as Health Sciences North in Sudbury, Ontario or the Yale-New Haven Health System in the United States have eliminated it entirely from their hospital formularies.

The American Society of Anesthesiologists (ASA) has also recommended a number of strategies, including utilizing low fresh gas flows, avoiding high impact inhaled anesthetics including nitrous oxide, using intravenous and regional anesthetic techniques, and investing in waste anesthetic gas trapping or destroying technology. More information on these suggestions can be found in their report, Greening the Operating Room and Perioperative Arena: Environmental Sustainability for Anesthesia Practice, produced by the ASA Task Force on Environmental Sustainability Committee on Equipment and Facilities.