Ecological Aspects for Clinical Application of Xenon

Xenon (Xe) is an inert noble gas with a distinctive pharmacological profile that combines anesthetic, analgesic, neuro- and cardioprotective properties, alongside stress-protective potential. This review synthesizes current concepts linking general anesthesia, sleep, and coma, and examines xenon’s NMDA-receptor antagonism as a driver of mitochondrial adaptation, including modulation of ROS signaling, calcium homeostasis, and cellular defense programs. From a clinical standpoint, we summarize randomized evidence on the efficacy and safety of xenon anesthesia, its impact on cognitive recovery and hemodynamic stability, and its prospective roles in intensive care and critical illness. Particular attention is given to environmental considerations: the comparative global warming potential of inhalational anesthetics, nitrous oxide’s contribution to ozone depletion, and the advantages of closed-circuit and low-flow delivery with xenon capture and recycling. Organizational and economic aspects of implementation are discussed (gas cost and equipment requirements), together with strategies to lower total cost of care via xenon’s rapid elimination, reduction of complications, and recovery of exhaled gas. In an interdisciplinary context, we outline xenon’s potential within pharmacological adaptation programs and prevention of professional burnout among healthcare workers. Overall, xenon emerges as a benchmark anesthetic with a high safety profile for patients and staff and a minimal ecological footprint. Future directions include expanding indications, standardizing recycling technologies, and integrating xenon therapy into sustainable anesthesia and critical care.