Association Between Anesthesia Provider Education and Carbon Footprint Related to the Use of Inhaled Halogenated Anesthetics

Chambrin, Coralie; Souza, S. De; Gariel, Claire; Chassard, D.; Bouvet, Lionel

doi:10.1213/ane.0000000000006172

Cited by 12 publications

(6 citation statements)

References 38 publications

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“…The reasons for this slow progress are unclear, but educational programs show promise in reducing greenhouse gas emissions [9,10]. In January 2023, the procurement of desflurane was halted in NHS Scotland, and NHS England has committed to phasing it out of routine anaesthetic practice by 2024 [25].…”

Section: Discussionmentioning

confidence: 99%

“…In our study, in the mixed strategy hospital, we noted that desflurane reduced by nearly half from 2021 to 2022, resulting in a drastic reduction in carbon footprint per intervention across the timescale of the study. Chambrin et al reduced desflurane use through an educational programme, resulting in a carbon footprint of around 6.5 kg CO 2 e per intervention for their optimised mixed strategy [9].…”

Section: Discussionmentioning

confidence: 99%

“…Chambrin et al. reduced desflurane use through an educational programme, resulting in a carbon footprint of around 6.5 kg CO 2 e per intervention for their optimised mixed strategy [9].…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Several studies have explored the potential reduction of the carbon footprint of anaesthesia through educational campaigns that encourage the transition from desflurane to sevoflurane, and the removal of nitrous oxide [9, 10]. Furthermore, the use of TIVA has been associated with a lower carbon footprint compared with volatile anaesthetic agents [7, 11–14].…”

Section: Introductionmentioning

confidence: 99%

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Reducing the carbon footprint of general anaesthesia: a comparison of total intravenous anaesthesia vs. a mixed anaesthetic strategy in 47,157 adult patients

Bernat,

Boyer,

Roche

et al. 2024

Anaesthesia

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SummaryGlobal warming is a major public health concern. Volatile anaesthetics are greenhouse gases that increase the carbon footprint of healthcare. Modelling studies indicate that total intravenous anaesthesia is less carbon intensive than volatile anaesthesia, with equivalent quality of care. In this observational study, we aimed to apply the findings of previous modelling studies to compare the carbon footprint per general anaesthetic of an exclusive TIVA strategy vs. a mixed TIVA‐volatile strategy. This comparative retrospective study was conducted over 2 years in two French hospitals, one using total intravenous anaesthesia only and one using a mixed strategy including both intravenous and inhalation anaesthetic techniques. Based on pharmacy procurement records, the quantity of anaesthetic sedative drugs was converted to carbon dioxide equivalents. The primary outcome was the difference in carbon footprint of hypnotic drugs per intervention between the two strategies. From 1 January 2021 to 31 December 2022, 25,137 patients received general anaesthesia in the hospital using the total intravenous anaesthesia strategy and 22,020 in the hospital using the mixed strategy. The carbon dioxide equivalent footprint of hypnotic drugs per intervention in the hospital using the total intravenous anaesthesia strategy was 20 times lower than in the hospital using the mixed strategy (emissions of 2.42 kg vs. 48.85 kg carbon dioxide equivalent per intervention, respectively). The total intravenous anaesthesia strategy significantly reduces the carbon footprint of hypnotic drugs in general anaesthesia in adult patients compared with a mixed strategy. Further research is warranted to assess the risk–benefit ratio of the widespread adoption of total intravenous anaesthesia.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Chambrin et al. reduced desflurane use through an educational programme, resulting in a carbon footprint of around 6.5 kg CO 2 e per intervention for their optimised mixed strategy [9].…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Reducing the carbon footprint of general anaesthesia: a comparison of total intravenous anaesthesia vs. a mixed anaesthetic strategy in 47,157 adult patients

Bernat,

Boyer,

Roche

et al. 2024

Anaesthesia

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Electricity consumption of anesthesia workstations and potential emission savings by avoiding standby

Drinhaus,

Schumacher

et al. 2024

Anaesthesiologie

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Background Anesthesiology has a relevant carbon footprint, mainly due to volatile anesthetics (scope 1 emissions). Additionally, energy used in the operating theater (scope 2 emissions) contributes to anesthesia-related greenhouse gas (GHG) emissions. Objectives Optimizing the electricity use of medical devices might reduce both GHG emissions and costs might hold potential to reduce anaesthesia-related GHG-emissions and costs. We analyzed the electricity consumption of six different anesthesia workstations, calculated their GHG emissions and electricity costs and investigated the potential to reduce emissions and cost by using the devices in a more efficient way. Methods Power consumption (active power in watt , W) was measured with the devices off, in standby mode, or fully on with the measuring instrument SecuLife ST. Devices studied were: Dräger Primus, Löwenstein Medical LeonPlus, Getinge Flow C, Getinge Flow E, GE Carestation 750 and GE Aisys. Calculations of GHG emissions were made with different emission factors, ranging from very low (0.09 kg CO2-equivalent/kWh) to very high (0.660 kg CO2-equivalent/kWh). Calculations of electricity cost were made assuming a price of 0.25 € per kWh. Results Power consumption during operation varied from 58 W (GE CareStation 750) to 136 W (Dräger Primus). In standby, the devices consumed between 88% and 93% of the electricity needed during use. The annual electricity consumption to run 96 devices in a large clinical department ranges between 45 and 105 Megawatt-hours (MWh) when the devices are left in standby during off hours. If 80% of the devices are switched off during off hours, between 20 and 46 MWh can be saved per year in a single institution. At the average emission factor of our hospital, this electricity saving corresponds to a reduction of GHG emissions between 8.5 and 19.8 tons CO2-equivalent. At the assumed prices, a cost reduction between 5000 € and 11,600 € could be achieved by this intervention. Conclusion The power consumption varies considerably between the different types of anesthesia workstations. All devices exhibit a high electricity consumption in standby mode. Avoiding standby mode during off hours can save energy and thus GHG emissions and cost. The reductions in GHG emissions and electricity cost that can be achieved with this intervention in a large anesthesiology department are modest. Compared with GHG emissions generated by volatile anesthetics, particularly desflurane, optimization of electricity consumption of anesthesia workstations holds a much smaller potential to reduce the carbon footprint of anesthesia; however, as switching off anesthesia workstations overnight is relatively effortless, this behavioral change should be encouraged from both an ecological and economical point of view.

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Environmental impact of intravenous versus oral administration materials for acetaminophen and ketoprofen in a French university hospital: an eco-audit study using a life cycle analysis

Bouvet,

Juif-Clément,

Bréant

et al. 2024

Can J Anesth/J Can Anesth

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Purpose The combination of acetaminophen with a nonsteroidal anti-inflammatory drug is the cornerstone of perioperative multimodal analgesia. These drugs can be administered intravenously or orally as premedication, consistent with the concept of pre-emptive and preventive analgesia. We aimed to assess the environmental impact of their intravenous and oral administration in a French university hospital. Methods We carried out a life cycle assessment to determine the amount of greenhouse gas emissions and depletion of water resources resulting from the oral vs intravenous administration of 1 g acetaminophen and 50 mg ketoprofen. We assessed two schemes of intravenous administration, depending on the use of the same or a different infusion set for each drug. Results At our centre, the intravenous administration of both drugs was associated with the emission of 444–556 g CO 2 equivalent (CO 2 e), and with 9.8–12.2 L of water waste. The oral administration of both drugs generated 8.36 g of CO 2 e emissions and consumed 1.16 L of water. At a national level, the switch from intravenous to oral premedication of the drugs could avoid the emission of 2,900–3,700 tons of CO 2 e and the waste of 58,000–74,000 m 3 of water each year. Conclusion This eco-audit indicates that oral administration of acetaminophen and ketoprofen results in significantly lower carbon emissions and water consumption than intravenous administration. These findings highlight the importance of using the oral route for most patients, limiting intravenous administration for those with specific needs because of higher environmental impact and cost.

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Association Between Anesthesia Provider Education and Carbon Footprint Related to the Use of Inhaled Halogenated Anesthetics

Abstract: Funding: S.deS. received a fee from the Association Générale de l'Internat de Lyon (general association of the residents of Lyon) to perform the statistical analyses.

Cited by 12 publications

References 38 publications

Reducing the carbon footprint of general anaesthesia: a comparison of total intravenous anaesthesia vs. a mixed anaesthetic strategy in 47,157 adult patients

Reducing the carbon footprint of general anaesthesia: a comparison of total intravenous anaesthesia vs. a mixed anaesthetic strategy in 47,157 adult patients

Electricity consumption of anesthesia workstations and potential emission savings by avoiding standby

Environmental impact of intravenous versus oral administration materials for acetaminophen and ketoprofen in a French university hospital: an eco-audit study using a life cycle analysis

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