Should pipeline nitrous oxide be discontinued in secondary care: A cost-benefit analysis

Nitrous oxide (N O) has seen a marked decline in its usage in recent years due to its adverse clinical effects. We audited the practice in our department to evaluate the N O consumption and cost-effectiveness of its supply. Electronic anesthesia records of all patients anesthetized in our main operating rooms in a typical month were reviewed retrospectively, and utilization of N O was noted in addition to the patient demographics, surgical procedure, and specialty. A total of 950 patients were anesthetized, and 3.1% received N O. The annual usage was estimated to be 72,871 liters, with a leakage of 3,883,105 liters to the environment, posing a safety hazard and wasting 149,612.50 SAR. Notable costs and environmental benefits may be achieved by substituting a piped supply of N O with portable E-cylinders on demand in operating rooms for rational use.