Using regional rather than general anaesthesia when possible may have significant environmental advantages, it has been claimed.
Dr Mausam Kuvadia and colleagues at the Hospital for Special Surgery in New York, USA, point out that benefits of regional anaesthesia are well known, but one potential benefit that has not been well described is the environmental impact.
In the journal Regional Anesthesia & Pain Medicine today (17 June), they explain that volatile halogenated gases and nitrous oxide, used as part of general anaesthetic, may contribute to global warming.
“Although the extent of the contribution of health care related activities to climate change is uncertain, health care professionals do have a responsibility,” they state.
“Following general anaesthetics, volatile halogenated agents and nitrous oxide are exhaled by the patient and released into the atmosphere. These gases have an atmospheric lifetime of up to 114 years, during which time they contribute to climate change as well as ozone destruction.”
Regional anaesthesia uses a local nerve block with intravenous sedatives, rather than volatile halogenated agents.
The authors give a real-life example of the 10,485 hip/knee replacements carried out at their hospital in 2019, of which only 4% were done under general anaesthetic. The authors calculate that this substitution ‘saved’ the equivalent of nearly 27,000 lbs of coal burned, 2750 gallons of petrol, 60,500 car miles, or 3,110,000 smartphones charged.
They write: “Studies estimate that anaesthetic gases contribute to approximately 50-60% of an operating theatre’s carbon footprint. Thus, increasing the use of regional anaesthesia is potentially good for the climate, improves the quality of care (at least for hip and knee replacements), and may allow individual practitioners to take personal responsibility in the fight against global warming.”
Kuvadia, M. et al. ‘Green-gional’ anesthesia: the non-polluting benefits of regional anesthesia to decrease greenhouse gases and attenuate climate change. Regional Anesthesia & Pain Medicine 17 June 2020 doi: 10.1136/rapm-2020-101452
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