Photo: Kristian Foden-Vencil/OPB
In anesthesiology, there are two primary gasses used to put patients under for their procedures–sevoflurane and desflurane. Generally during surgery whatever the patient does not inhale is pumped outside at a detriment to our planet because both gasses are potent greenhouse gasses. But as anesthesiologist Brian Chesebro discovered, desflurane is 20 times as powerful in trapping heat in Earth’s atmosphere as sevoflurane. It also lasts for 14 years in the atmosphere, whereas sevoflurane breaks down in just one year. Chesboro has been on a mission to get his hospital and anesthesiologists around the country to begin making the switch from desflurane to sevoflurane, a move that would shift the emissions of one surgery from releasing the GHG equivalent of driving a fleet of 12 humvees to only half a hummer.
As Popular Science explained, “In more concrete terms, the anesthesia one mid-size hospital uses in a year contributes the same emissions as up to 1,200 cars.”
In 2012 the medical journal Anesthesia & Analgesia conducted a study into the GHG potential of the most commonly used anesthetic gases and concluded that:
“Desflurane and nitrous oxide should be restricted to cases where they may reduce morbidity and mortality over alternative drugs. Clinicians should avoid unnecessarily high fresh gas flow rates for all inhaled drugs. There are waste anesthetic gas capturing systems, and even in advance of reprocessed gas applications, strong consideration should be given to their use.”
The researchers of the Anesthesia & Analgesia study recommend that even if desflurane can be recycled that the method should not be prioritized. Their recommendation was that “clinicians may elect to avoid desflurane and N2O, or choose to substitute total IV anesthesia instead of general inhaled anesthesia.”
Why This Matters: According to one NCBI study, the global warming potential (GWP) of a halogenated anesthetic is up to 2,000 times greater than CO2. While this research has been available for quite some time, it will perhaps take the activism of doctors like Brian Chesebro to make his profession more aware of how they’re contributing to climate change. After all, the World Health Organization calls climate change the greatest threat to global health in the 21st century, thus the medical community shouldn’t be contributing to this threat if they can help it. Additionally, there are no current regulations for how much of these gases a hospital or surgical center can emit, and anesthetic gases aren’t a part of the Paris Climate Accord–it’s time we change this.
May 13, 2019 » anesthesia, GHGs, medicine
