Estimate of the total carbon footprint and component carbon sources of different modes of labour analgesia

Anaesthesia and environment: impact of a green anaesthesia on economics

“…Availability of these options varies greatly between countries and hospitals. In the UK, it is recommended that N 2 O should be available in all birth settings, which has led to 30% of all GHG emissions of anaesthetic services attributable to N 2 O administration in the labour setting [ 54 ▪ ]. A recent study compared the total carbon footprint in CO 2 -eq of 4-h periods of different modes of labour analgesia.…”

Implementing nitrous oxide cracking technology in the labour ward to reduce occupational exposure and environmental emissions: a quality improvement study*

“…Free text feedback was sought about the size of the machine relative to the size of the room. Of the 22 respondents with experience of using the equipment, 19 commented that the machine was larger than they would wish (``Could be smaller due to everything else that needs to be in the room The introduction of cracking technology to maternity units may be an invaluable method of reducing the carbon footprint of N 2 O. Whilst analgesic alternatives such as epidurals and remifentanil may have a lower carbon footprint as well as higher analgesic efficacy [18], these techniques may not be desirable or acceptable to many parturients. Furthermore, the risks and burdens inherent to these techniques mean they cannot be delivered in the midwifery-led setting without medical involvement and continuous fetal monitoring [7].…”

“…However, even with 75% destruction, N 2 O would still have a higher carbon footprint than other methods of labour analgesia [12]. Based on the calculations of [18].…”

“…However, even with 75% destruction, N 2 O would still have a higher carbon footprint than other methods of labour analgesia [12]. Based on the calculations of Pearson et al., a 75% N 2 O capture rate over a 4‐h period of labour would reduce N 2 O related emissions from 237.33 kgCO 2 e to 59.33 kgCO 2 e (remifentanil patient‐controlled analgesia 0.75 kgCO 2 e; epidural bupivacaine 1.2 kgCO 2 e; intramuscular morphine 0.08 kgCO 2 e) [18]. The extent to which these comparisons should be discussed with patients as part of the consent process remains a matter of some controversy [28], and should be investigated in future study.…”

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“…126 127 Furthermore, it is a major cause of ongoing ozone depletion. 128 Introduction of NOX capture and catalytic destruction devices in Swedish hospitals and maternity units resulted in a 50% reduction in GHG emissions in maternity services, 129 but this is an additional cost pressure (as well as manufacturing demand for new equipment). Consideration should be given to substituting for other low-impact methods.…”