Professional practice guidelines: eco-responsible optimization of choice and use of drugs and medical devices in operating theaters or interventional sector

To provide recommendations for eco-responsible optimization of choice and use of medicines and medical devices.

A committee of 16 experts brought together by CERES and from SPFDM/Euro-Pharmat, SFAR, SFCR, SFED, SF2H, SFPC, SFR, SF2S has been set up. A policy for declaring links of interest was applied and respected throughout the process of creating the reference system. Similarly, it has not provided any funding from a company marketing a health product (drug or medical device). The committee had to respect and follow the GRADE® method (Grading of Recommendations Assessment, Development and Evaluation) to assess the quality of the evidence on which the recommendations were based.

The recommendations were formulated by identifying 4 different fields: practice of care (optimization of medicines and medical devices), packaging (reduction of the environmental impact of medical devices), organization of care (integration of environmental criteria) and waste management (reduction, sorting and recovery). Each question was formulated according to the PICO (Patients, Intervention, Comparison, Outcome) format. The analysis of the literature and the recommendations were carried out according to the GRADE® methodology.

The experts' synthesis work resulted in 46 recommendations validated after one round of voting. For all questions, since the GRADE grid ® method could not be applied in full, the recommendations were formulated in the form of expert opinions.

From a strong agreement between experts, we were able to formulate 46 recommendations for eco-responsible optimization of the choice and use of medicines and medical devices.

Published by Anaesthesia, critical care & pain medicine, 2026. The guideline itself is at the source linked here.

doi.org/10.1016/j.accpm.2026.101772