Abstract / Summary
Abstract Background Environmental pollution and global warming are major global concerns, with healthcare contributing approximately 4.4% of global greenhouse gas emissions. Perioperative and anesthesia services contribute substantially through the use of single-use materials and volatile anesthetics. However, evidence on sustainability in anesthesia is largely derived from high-income countries, with limited data from Latin America. This study aimed to assess anesthesiologists’ perspectives, practices, and perceived barriers regarding environmental sustainability in daily clinical practice in a southwestern Colombian city. Methods A cross-sectional study using mixed methods (online survey and focus groups) was conducted with all active anesthesiologists and residents of anesthesiology (n = 85) in Popayán, Cauca, and surrounding areas, achieving a 100% response rate. Data collection involved an anonymous online survey with closed and open-ended questions, complemented by two semi-structured focus groups to explore perceptions, attitudes, and knowledge. Descriptive statistics were used for the survey results, and thematic analysis was applied to the qualitative data. Results Most participants were certified anesthesiologists (88.2%) and primarily practiced in public hospitals (74.1%). Overall, 95.3% agreed or strongly agreed that sustainability is important in their professional practice, and 94.1% reported that anesthesiology has a substantial environmental impact. Solid waste and single-use plastics were identified as the primary environmental concern by 50.6% of respondents, followed by anesthetic gases (37.6%). The most frequently reported sustainable practices were deliberate selection of anesthetic techniques, including low fresh-gas flows and regional anesthesia (27.1%), followed by supply optimization and recycling initiatives (22.4%). Systemic factors, including administrative constraints, cost considerations, and limited resources, were reported as the main barrier to broader implementation (42.4%). Conclusions We found a high degree of environmental awareness and ethical commitment among Colombian anesthesiologists. However, systemic barriers (administrative factors, cost, and inadequate infrastructure) demonstrate that enabling sustainable practice requires institutional policy and economic commitment to invest in cost-saving, high-impact strategies rather than solely relying on individual clinician motivation. Clinical trial number: not applicable.