The environmental footprint and ecotoxicity of sevoflurane and propofol anaesthesia: do conservative modelling assumptions overstate the ecotoxicity of propofol? Comment on Br J Anaesth 2026; 137: 89–98

This article discusses the environmental footprint and ecotoxicity of anaesthesia administered using sevoflurane and propofol. The authors comment on a recent study by Bernat and colleagues, which compared the impact of these anaesthetics on aquatic environments. They highlight the importance of a discussion that extends beyond just the climate effects of anaesthetic choices. It was generally assumed that sevoflurane has greater climate impacts, while propofol was associated with aquatic ecotoxicity. However, the findings of Bernat and colleagues suggest the opposite. Their study showed that the environmental effects of sevoflurane, including both climate and aquatic impacts, significantly outweigh those of propofol. This challenges previous assumptions about the relative ecotoxicity of these two anaesthetics.