{"title":"Anaesthetic gases and the environment: Is it time for a rethink?","authors":"","doi":"10.1016/j.surge.2024.04.014","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p><span>General anaesthesia<span> is in common use for patients undergoing surgical procedures, with the option of both inhalational and intravenous anaesthetic techniques. </span></span>Anaesthetic gases are often excluded from discussions on sustainable healthcare delivery, despite being a significant contributor to the overall environmental impact of healthcare services.</p></div><div><h3>Methods</h3><p>A literature review was carried out on previously published papers on the impact anaesthetic gases have on our environment and at ways to reduce their impact in current anaesthetic practice. The aim was to write a narrative review detailing the areas of concern as well as the current clinical situation in the European setting.</p></div><div><h3>Summary/conclusions</h3><p>The two classes of inhaled anaesthetic<span><span><span> agent most frequently used are nitrous oxide<span> and volatile agents (most commonly </span></span>sevoflurane, </span>isoflurane and desflurane). Both are recognised greenhouse gases that contribute to climate change.</span></p><p><span><span><span>Minor modifications in the use of anaesthetic gases can have a significant environmental impact. These modifications include avoiding nitrous oxide whenever possible, avoiding </span>desflurane<span> (and using sevoflurane<span> instead), using low flow anaesthesia during maintenance, swapping volatile-based anaesthesia for a </span></span></span>TIVA technique when clinically appropriate and considering the use of central neuraxial or </span>regional anaesthesia in place of general anaesthesia when possible.</p></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"22 4","pages":"Pages 200-202"},"PeriodicalIF":2.3000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1479666X24000465","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
Abstract
Background
General anaesthesia is in common use for patients undergoing surgical procedures, with the option of both inhalational and intravenous anaesthetic techniques. Anaesthetic gases are often excluded from discussions on sustainable healthcare delivery, despite being a significant contributor to the overall environmental impact of healthcare services.
Methods
A literature review was carried out on previously published papers on the impact anaesthetic gases have on our environment and at ways to reduce their impact in current anaesthetic practice. The aim was to write a narrative review detailing the areas of concern as well as the current clinical situation in the European setting.
Summary/conclusions
The two classes of inhaled anaesthetic agent most frequently used are nitrous oxide and volatile agents (most commonly sevoflurane, isoflurane and desflurane). Both are recognised greenhouse gases that contribute to climate change.
Minor modifications in the use of anaesthetic gases can have a significant environmental impact. These modifications include avoiding nitrous oxide whenever possible, avoiding desflurane (and using sevoflurane instead), using low flow anaesthesia during maintenance, swapping volatile-based anaesthesia for a TIVA technique when clinically appropriate and considering the use of central neuraxial or regional anaesthesia in place of general anaesthesia when possible.
期刊介绍：
Since its establishment in 2003, The Surgeon has established itself as one of the leading multidisciplinary surgical titles, both in print and online. The Surgeon is published for the worldwide surgical and dental communities. The goal of the Journal is to achieve wider national and international recognition, through a commitment to excellence in original research. In addition, both Colleges see the Journal as an important educational service, and consequently there is a particular focus on post-graduate development. Much of our educational role will continue to be achieved through publishing expanded review articles by leaders in their field.
Articles in related areas to surgery and dentistry, such as healthcare management and education, are also welcomed. We aim to educate, entertain, give insight into new surgical techniques and technology, and provide a forum for debate and discussion.
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