Reducing Nitrous Oxide Emissions Across the Melbourne Biomedical Precinct.

Robertson, Ross; Downey, Andrew; Williams, Daryl; Makein, Bjorn; Dunne, Ben; Ozturk, Tugce; Gu, Ying; McIntyre, Rebecca · Med J Aust · 2026

case_series · Level IV

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Abstract

Nitrous oxide (N<sub>2</sub>O) accounts for the majority of Australian healthcare's direct anaesthetic gas-related greenhouse gas emissions due to reticulated system leaks. Updated Australasian guidelines no longer mandate a reticulated N<sub>2</sub>O supply. We present the efforts of four Melbourne hospitals to reduce N<sub>2</sub>O emissions across diverse clinical contexts. Two have decommissioned reticulated N<sub>2</sub>O and adopted cylinder supplies as required through clinical consultation and interdisciplinary collaboration. Two face ongoing high clinical demand for N<sub>2</sub>O, with multiple locations sharing infrastructure, and are pursuing audits and trials to guide change. These case studies illustrate the diverse strategies and challenges involved in reducing N<sub>2</sub>O emissions.

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