Healthcare is a significant producer of greenhouse gases. Emissions are produced both directly from gas and electricity use, and indirectly from the consumption of goods and services.¹

A 2019 Healthcare Without Harm and Arup report estimated that healthcare contributes 4.4% of global greenhouse gas emissions. NHS UK is responsible for 5,4% and US accounts for 7.6% of the total. ^{1, 2}

The environmental impacts of gas anaesthesia

Although different anaesthetic gases have varying levels of potency all of them are contributing to climate crisis³ Greenhouse gases used in anaesthesia absorb and remit heat which causes a temperature raise. Desflurane is over 2,500 times more warming than carbon dioxide, and an hour of anaesthetic use is an equivalent of 30-60kg of CO₂ (equivalent of driving 200-400km) In comparison sevoflurane have a warming effect of 800-1,600 g of CO₂ (driving 5-10km) ⁴. Over 42% of carbon emissions generated during a single procedure are caused by anaesthetic gases ⁹

The environmental impacts of anaesthesia also extend beyond gases being released directly into the atmosphere, as the surrounding life cycle of the drugs also contributes. For instance, drug manufacturing, transportation and disposal have environmental impacts.⁵

Reducing the environmental impacts of anaesthesia

Published guidelines

The Association of Anaesthetists (AOA) published a guide to improve the impact of anaesthesia on the environment. The guide states that the greatest impact of anaesthesia comes from the use of gases with significant global warming potential. It also suggests:

•        Avoiding the use of desflurane except when it is necessary
•       Swapping volatile agent-based anaesthesia for total intravenous anaesthetic (TIVA)¹⁰

Offsetting medical carbon footprint

Calculating impact

The first step in reducing medical carbon footprint is understanding the impact of the care being delivered. The AOA has created a calculator to help healthcare professionals calculate and understand both the financial cost and the CO₂ equivalence of inhalation anaesthesia. Although the calculator doesn’t provide an exact measure, it could be used for setting a target while working towards reducing the environmental impact.

TIVA

Propofol- based TIVA provides an alternative technique for anaesthesia induction, without requiring the use of volatile agents. The study from 2012 concludes:

“Propofol has the least overall impact on GHG emissions, even assuming a 50% wastage rate, disposable plastics for IV administration, and the energy requirements of the infusion pump.” ⁵

What is more TIVA reduces the risk of PONV (postoperative nausea and vomiting), which influences the length of patients’ stay in PACU (post anaesthesia care unit) and the use of hospital facilities.

Addressing environmental issues

Mediplus is supporting Project Seagrass, which is dedicated to conserving seagrass ecosystems globally. Restoration of seagrasses aids biodiversity and leads to accelerated CO² absorption. In under a decade, Project Seagrass has planted over 1 million seagrass seeds recovering thousands of miles of this unique ecosystem, providing habitat for millions of species and stabilizing the sea bottom. Mediplus is a proud platinum sponsor of Project Seagrass

Additionally, Mediplus TIVA Sets are designed to minimise postoperative drug wastage.

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