• If our healthcare system were a country, it would rank 13
th
in the
world for greenhouse emissions.
Unfortunately, capturing and evacuating waste anesthetic gas in the
OR is not an environmentally friendly option. OSHA regulations that
call for protecting surgical team members from exposure to inhalation-
al anesthetics by mandating the use of scavenger systems don't go far
enough.
"The systems suction waste gas out of the room, but often send it up
through vents on facility roofs and out into the atmosphere in unregu-
lated amounts," says Jodi Sherman, MD, director of sustainability and
the department of anesthesia at Yale-New Haven Health System in
New Haven, Conn.
What can you do to go green with anesthesia gases? Here are 3
straightforward interventions.
• Sevoflurane instead of desflurane. Desflurane and nitrous oxide
have the highest potential impact on global warming. When it comes
to reducing how much gas is distributed into the environment, Dr.
Sherman says minimizing or avoiding the use of desflurane and
nitrous oxide is the most effective.
Desflurane is also the most expensive of the inhalational agents.
Anesthesia providers might not be aware of those drawbacks associ-
ated with desflurane and, besides, patients who receive the anesthetic
emerge faster and recover more quickly — factors that are said to off-
set the additional cost of the agent.
However, improved clinical efficiencies have not been definitely
linked to desflurane in the literature, says Dr. Sherman. Plus, you can
replicate the positive properties of desflurane with other agents. "It's
not an essential drug," says Dr. Sherman. "No matter which anesthetic
you use, you can titrate the drug to wake up patients as quickly as pos-
sible."
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