Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street Gray Bigelow 444, Boston, MA 02114, USA.
Anesth Analg. 2011 Jan;112(1):213-7. doi: 10.1213/ANE.0b013e3181fe02c2. Epub 2010 Nov 3.
General anesthetics are administered to approximately 50 million patients each year in the United States. Anesthetic vapors and gases are also widely used in dentists' offices, veterinary clinics, and laboratories for animal research. All the volatile anesthetics that are currently used are halogenated compounds destructive to the ozone layer. These halogenated anesthetics could have potential significant impact on global warming. The widely used anesthetic gas nitrous oxide is a known greenhouse gas as well as an important ozone-depleting gas. These anesthetic gases and vapors are primarily eliminated through exhalation without being metabolized in the body, and most anesthesia systems transfer these gases as waste directly and unchanged into the atmosphere. Little consideration has been given to the ecotoxicological properties of gaseous general anesthetics. Our estimation using the most recent consumption data indicates that the anesthetic use of nitrous oxide contributes 3.0% of the total emissions in the United States. Studies suggest that the influence of halogenated anesthetics on global warming will be of increasing relative importance given the decreasing level of chlorofluorocarbons globally. Despite these nonnegligible pollutant effects of the anesthetics, no data on the production or emission of these gases and vapors are publicly available. The primary goal of this article is to critically review the current data on the potential effects of general anesthetics on the global environment and to describe possible alternatives and new technologies that may prevent these gases from being discharged into the atmosphere.
在美国，每年约有 5000 万名患者接受全身麻醉。在牙医诊所、兽医诊所和动物研究实验室中，也广泛使用麻醉蒸气和气体。目前所有使用的挥发性麻醉剂都是破坏臭氧层的卤代化合物。这些卤代麻醉剂可能对全球变暖产生潜在的重大影响。广泛使用的麻醉气体氧化亚氮是一种已知的温室气体，也是一种重要的消耗臭氧气体。这些麻醉气体和蒸气主要通过呼气排出，而不会在体内代谢，并且大多数麻醉系统将这些气体作为废物直接不变地转移到大气中。很少有人考虑气态全身麻醉剂的生态毒理学特性。根据最近的消费数据，我们的估计表明，氧化亚氮的麻醉使用在美国的总排放量中占 3.0%。研究表明，鉴于全球氯氟烃水平的下降，卤代麻醉剂对全球变暖的影响将变得越来越重要。尽管这些麻醉剂具有不可忽视的污染影响，但目前还没有关于这些气体和蒸气的生产或排放的数据。本文的主要目的是批判性地审查全身麻醉对全球环境的潜在影响的现有数据，并描述可能的替代方案和新技术，以防止这些气体排放到大气中。
