When it comes to environmental sustainability a big question is often ‘how can we make meaningful changes?’. Things like biking instead of driving to work, augmenting energy consumption with solar panels at home, and reducing waste often come to mind.
But a major contributor to greenhouse gas emissions has nothing to do with vehicles or remembering to turn the lights off when you leave a room, including the operating room.
Surgical procedures create a large amount of environmental waste thanks to the use of anesthesia gases.[1] These gases can live in the atmosphere for decades and contribute to global warming.
Sevoflurane has a lower impact compared to other gases and has a shorter atmospheric lifespan but there is still room for improvement when it comes to reducing emissions caused by anesthesia procedures.1
The GE HealthCare Sustainability in Anesthesia Webinar Series features three experts from Australia during their second webinar in July 2022 discussing one of these strategies – utilizing low-flow anesthesia. Dr. Alain Kalmar, Dr. Cas Woinarski, and Dr. Ross Kennedy discussed current research surrounding low-flow anesthesia, barriers regarding low-flow practice adoption, and how big data can help address common barriers.
Big data has the potential to provide anesthesiologists with information and motivation to change practice to low-flow anesthesia to not only reduce greenhouse gas emissions, but to reduce overall costs for healthcare systems.
Adoption of Low-Flow Technology Can Save Money and Reduce Ecological Impact
Using sevoflurane instead of desflurane is one way to improve environmental sustainability in the surgical setting1. Sevoflurane has a much lower environmental impact, but still contributes to greenhouse gas emissions.
Dr. Kalmar cites a 1994 article reviewing the specific gravities of various anesthesia gases and notes one 250 ml bottle of sevoflurane is the equivalent of 266 kg of CO2 emissions.[2]
For reference, one bottle of sevoflurane is the equivalent of:
- 111 liters of gasoline
- 2600 km of airline travel
- 1773 km driving
At Maria Middelares General Hospital where Dr. Kalmar practices, sevoflurane consumption was 717 L in 2014. This consumption cost nearly €300,000 and was the equivalent of burning 319,000 L of gasoline.[3] Due to this high level of consumption contributing to greenhouse gases and rising healthcare costs, he studied the impact of using low-flow anesthesia during surgery.
He found when using low-flow anesthesia with end-tidal control software (exclusively to the AisysTM CS2 anesthesia machine) applied with an automated gas control algorithm, consumption could be reduced by more than half during a 40-minute period.3
This reduction could result in annual cost savings of over €5,000-10,000. If sevoflurane is used this could reduce CO2 emissions by 11 tons each year and if desflurane is used the savings would be an astonishing 270 tons annually.3
Using algorithms to facilitate low-flow practices have the potential to help standardize anesthetist practice. Currently, practices vary widely based on location and training. Another way is to use big data to gather data on anesthetist practice.
By doing this, practice patterns can be reviewed with the entire team to identify areas of opportunity. This information can also be reviewed confidentially with individuals to show their own patterns of consumption compared to their colleagues.
