Lost in the Ether: The Environmental Impact of Anesthesia

Herr, Molly M.; Outterson, Rachel E.; Aggarwal, Shreya

doi:10.1016/j.oto.2022.100997

Cited by 7 publications

(4 citation statements)

References 41 publications

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“…Additionally, multiple recent studies have shown that 75%-95% of purchased nitrous oxide leaks out of the nitrous oxide central pipeline prior to even being available for clinical use. [12][13][14] This is concerning for occupational exposures and is, in any case, a profligate use of resources. Utilizing E-cylinders for delivery of nitrous oxide, rather than the central pipeline, reduces the leak substantially.…”

Section: Re a Son: Why Fix Some Thing That Is Not B Rok Enmentioning

confidence: 99%

“…There may be additional risks for anesthesiologists and anesthetists with B12 deficiency due to known inactivation of methionine synthetase by nitrous oxide. Additionally, multiple recent studies have shown that 75%–95% of purchased nitrous oxide leaks out of the nitrous oxide central pipeline prior to even being available for clinical use 12–14 . This is concerning for occupational exposures and is, in any case, a profligate use of resources.…”

Section: Reason: Why Fix Something That Is Not Brokenmentioning

confidence: 99%

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It's time to stop using nitrous oxide for pediatric mask induction

Gordon,

Chatterjee,

McGain

2023

Pediatric Anesthesia

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BackgroundMask induction of anesthesia for pediatric patients has included the use of nitrous oxide since the inception of pediatric anesthesia. However, the use of nitrous oxide precludes adequate preoxygenation. Additionally, pediatric physiology (less Functional Residual Capacity, higher oxygen consumption), increased risk of laryngospasm and lack of intravenous access increase the risk of a severe airway complication in the event of airway occlusion. Nitrous oxide does not facilitate tranquil mask placement on an unwilling child and does not meaningfully speed mask induction. Exposure to nitrous oxide has potential occupational health concerns and nitrous oxide has significant environmental detriment.ConclusionUtilizing other, evidence‐based, techniques to facilitate tranquil mask placement will assure that patients have a pleasant induction experience and avoiding nitrous oxide will reduce the environmental impact, as well as improve the safety of, pediatric mask induction.

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Section: Re a Son: Why Fix Some Thing That Is Not B Rok Enmentioning

confidence: 99%

Section: Reason: Why Fix Something That Is Not Brokenmentioning

confidence: 99%

It's time to stop using nitrous oxide for pediatric mask induction

Gordon,

Chatterjee,

McGain

2023

Pediatric Anesthesia

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show abstract

“…Hastanelerin karbon emisyonlarının yaklaşık %5'i inhalasyon anesteziklerinden kaynaklanırken, aynı zamanda bir hastanenin tüm atıklarının yaklaşık %20'si ameliyathanelerde üretilmektedir. İnhalasyon anesteziklerinin yaygın kullanımı, cihazlar, tek kullanımlık plastiklerin yüksek düzeyde geri dönüştürülmemiş atığa yol açması, havalandırma ve oksijen (O 2 ) temini için genel enerji tüketimi ile ameliyathaneler muazzam bir karbon ayak izine sahiptir (28).…”

Section: Anestezi̇ni̇n Küresel Isinmaya Ve çEvreye Etki̇si̇unclassified

“…Bu çalışmada, sevofluran kullanımında gözlenen artış, desfluran kullanıcılarının diğer stratejileri (total intravenöz anestezi, rejyonal anestezi) kullanmak yerine sevoflurana geçtiğini ve bunun da karbon ayak izini azaltmış olabileceğini düşündürmektedir (48). Rejyonal anestezi daha az ilaç ve malzemenin kullanıldığı nispeten daha basit bir yöntem olduğundan, uygun operasyonlarda, savaş hastaneleri veya düşük ve orta gelirli ülkeler gibi kaynak sıkıntısı çekilen ortamlarda özellikle tercih edilmektedir (28). Rejyonal anestezinin başka çevresel faydaları da olabilir.…”

Section: çEvresel Etkileri Daha Düşük Olan Anestezik Gazların Seçilmesiunclassified