contributed to this evidence-based project in fulfillment of the degree of Doctor of Nurse Anesthesia Practice at Gonzaga University and Providence Sacred Heart Medical Center in Spokane, Washington, in 2019. Email:
contributed to this evidence-based project in fulfillment of the degree of Doctor of Nurse Anesthesia Practice at Gonzaga University and Providence Sacred Heart Medical Center in 2019.
AANA J. 2021 Feb;89(1):27-33.
Volatile anesthetic agents act as greenhouse gases. Low-flow anesthesia techniques (≤1 L/min) are associated with lower costs. Decreasing volatile anesthetic delivery provides safe and effective strategies for anesthesia providers to decrease costs and reduce environmental pollution. This evidence-based project aimed to estimate cost savings and reduction in the environmental release of anesthetic gases, under simulated lower fresh gas flow (FGF) practices. For each surgical case, the exhaled anesthetic gas percent and FGF data were used to calculate the volume of fluid volatile anesthetic. The fluid volatile anesthetic for each case was then estimated using simulated FGFs. Changes in volatile agent cost and environmental release of anesthetic gases were predicted. Sevoflurane was the most commonly used volatile agent. The mean FGF for cases using sevoflurane was 2.5 L/min. The simulated FGF of 1 L/min FGF across all agents predicted a 48% ($50,892) reduction in costs of volatile anesthetics and a 42% (33 metric tons of carbon dioxide equivalent) decrease in carbon emissions. Simulated low-flow anesthesia demonstrated cost savings and environmental conservation. Project findings align with current literature showing that lowering FGFs represents an area of cost containment and an opportunity to lessen the environmental impact of anesthesia.
挥发性麻醉剂是温室气体。低流量麻醉技术(≤1 升/分钟)与较低的成本相关。减少挥发性麻醉剂的输送为麻醉师提供了安全有效的策略,以降低成本和减少环境污染。这个基于证据的项目旨在估计在模拟较低新鲜气流(FGF)实践下的成本节约和麻醉气体环境释放的减少。对于每个手术病例,使用呼出的麻醉气体百分比和 FGF 数据来计算流体挥发性麻醉剂的体积。然后使用模拟的 FGF 来估算每个病例的流体挥发性麻醉剂。预测了挥发性麻醉剂成本和麻醉气体环境释放的变化。七氟醚是最常用的挥发性麻醉剂。使用七氟醚的病例的平均 FGF 为 2.5 升/分钟。所有药物的模拟 FGF 为 1 升/分钟,预计可降低 48%(50892 美元)的挥发性麻醉剂成本和 42%(33 吨二氧化碳当量)的碳排放。模拟的低流量麻醉显示出成本节约和环境保护。项目结果与当前文献一致,表明降低 FGF 是成本控制的一个领域,也是减轻麻醉对环境影响的机会。