The Carbon Footprint of Clinical Artificial Intelligence in Anaesthesiology: An Order-of-Magnitude Comparison with Current Clinical Practice.

Artificial intelligence (AI) is rapidly reshaping anaesthesiology and critical care, enhancing physiological monitoring, perioperative risk prediction, and clinical decision-making. As its adoption accelerates, attention has increasingly turned to the environmental consequences of digital healthcare, raising important questions regarding the energy consumption and carbon footprint associated with clinical AI. This study examines the environmental implications of AI in anaesthesiology and critical care by placing computational emissions within the broader context of healthcare sustainability. Current evidence indicates that, although AI systems generate measurable greenhouse gas emissions, their operational carbon footprint remains several orders of magnitude lower than that of established sources of emissions, including volatile anaesthetic agents, intensive care, and surgical care. Quantitative comparisons, complemented by an illustrative environmental break-even analysis, suggest that even modest improvements in healthcare efficiency may be sufficient to offset the operational emissions of current clinical AI applications. These findings indicate that the sustainability of clinical AI should not be judged solely by its computational footprint, but by its overall environmental value. The relevant question is not simply how much AI emits, but whether its implementation reduces resource utilisation, avoids unnecessary healthcare activities, and generates environmental savings that outweigh its own operational costs. Achieving this objective will require computationally efficient model design, low-carbon digital infrastructures, lifecycle assessment, and the routine integration of environmental metrics into AI evaluation. Rather than representing a major new source of healthcare emissions, clinical AI should be viewed as an opportunity to advance both digital innovation and environmental stewardship. By integrating sustainability alongside clinical effectiveness, anaesthesiologists are uniquely positioned to guide the responsible development and implementation of AI technologies that benefit both patients and the healthcare systems in which they are delivered.