Nitrous oxide (N2O) is a medical gas that has a current role in labour analgesia, and a limited role in procedural sedation and paediatric anaesthesia. It is also a greenhouse gas and contributes to the climate crisis. It has an atmospheric lifetime of over 100 years and a direct destructive effect on atmospheric ozone. Evidence suggests that a large proportion of medical N2O (often over 90%) purchased by healthcare facilities leaks into the environment from the N2O reticulation infrastructure before it is used for patient care.
DEA holds the position that reticulated N2O systems are a source of unnecessary environmental harm through undetected leaks. Point of care cylinder supply can mitigate this leak whilst still meeting clinical requirements for patients, particularly in labour analgesia with limited roles in anaesthesia and procedural sedation. The intent of this position statement is to limit environmental harm through decreasing wasteful emissions rather than influencing clinical practice, while appreciating that the role of N2O in healthcare is now mainly in labour analgesia, with limited roles in anaesthesia and procedural sedation.
Healthcare facility nitrous oxide infrastructure Position Statement - PDF (November 2024)