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Saturday, February 24, 2024

Anesthesiologists are reducing greenhouse gas emissions in operating rooms

Fresh gas flow rates and more eco-friendly anesthetics are allowing medical staff to reduce their impact on climate change


By KATIE HELLMAN — science@theaggie.org 


University of California medical facilities, including UC Davis, have been making multiple changes to reduce the amount of greenhouse gases emitted during surgical procedures, according to a recent study in the Journal of Medical Internet Research Publications.

Real-time clinical decision support (CDS) systems lower anesthetic gas waste by prompting anesthesia professionals to reduce fresh gas flow (FGF) when a set threshold is exceeded,” the study reads.

Desflurane, which is frequently used in operating rooms by anesthesiologists, is a greenhouse gas that causes a significant amount of pollution. One hour of using the gas is equivalent to the emissions produced from driving a car for 400 miles. UC Davis Health has replaced desflurane with sevoflurane, a more eco-friendly option, in its operating rooms as a result.

Emily Methangkool, co-author of the study and an anesthesiologist at UCLA Health, commented on the impact of these gases.

“The gases we use for putting patients to sleep and keeping patients asleep are potent greenhouse gases and ozone depleters,” Methangkool said via email. “There are certain gases that are worse offenders than others, so we are trying to use the ones with less greenhouse gas impact.”

Nina Schloemerkemper, a professor and clinical director of obstetric anesthesia at UC Davis Health, provided insight into an often-overlooked impact that medical facilities have on the planet.

“The healthcare sector in the U.S. is probably responsible for 10-30% of U.S. greenhouse gas [emissions],” Schloemerkemper said.

A typical surgical procedure involves administering sedation to patients and helping them breathe through tracheal tube intubation. The patients are kept unconscious by using a breathing machine that continuously supplies them with anesthetic.

Allowing more anesthesia to be re-used by the patient every time they breathe can also significantly reduce the production of greenhouse gases during surgeries, without negatively affecting patients or altering their unconscious state during procedures.

“The patient exhales and then breathes back in, and we recycle the air,” Schloemerkemper said. “We are taking out the carbon dioxide that they have produced and adding extra oxygen.”

UC Davis is working on providing medical staff with fresh gas flow rates and displaying their sevoflurane usage on an online dashboard, which would alert them when an anesthetic exceeds a specific usage. Researchers hope this will reduce emissions from anesthesia by over 50%, and these changes are being put into effect at other institutions as well.

“We can decrease how much oxygen and air is delivered to the patient while maintaining patient safety, and that will reduce how much anesthetic gas is needed for the procedure (and also how much is sent into the atmosphere),” Methangkool said.

Written by: Katie Hellman — science@theaggie.org