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• Conduct regular monitoring of airborne concentrations of waste gas
• Minimize fresh gas flow rates; switch to low flow or closed anesthesia systems
• Utilize efficient ventilation and scavenging systems
• Ensure anesthesia equipment is well-maintained without leaks
• Decommission or avoid construction of central nitrous oxide piping
• Portable E cylinders should be substituted in those locations where nitrous oxide use is considered essential
• Select anesthetic agents with lower GHG emissions (remove desflurane from formularies)
• Consider total intravenous anesthesia (TIVA) as an alternative to volatile/inhaled anesthetics
• Follow appropriate procedures for the disposal of IV anesthetics
• Switch to metered-dose inhaler alternatives (e.g., soft mist or dry powder)

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