Gaya da Costa Mariana, Kalmar Alain F, Struys Michel M R F
Department of Anesthesiology, University of Groningen, University Medical Center Groningen, 9713GZ Groningen, The Netherlands.
Department of Anesthesia and Intensive Care Medicine, Maria Middelares Hospital, 9000 Ghent, Belgium.
J Clin Med. 2021 Mar 22;10(6):1306. doi: 10.3390/jcm10061306.
Inhaled anesthetics have been in clinical use for over 150 years and are still commonly used in daily practice. The initial view of inhaled anesthetics as indispensable for general anesthesia has evolved during the years and, currently, its general use has even been questioned. Beyond the traditional risks inherent to any drug in use, inhaled anesthetics are exceptionally strong greenhouse gases (GHG) and may pose considerable occupational risks. This emphasizes the importance of evaluating and considering its use in clinical practices. Despite the overwhelming scientific evidence of worsening climate changes, control measures are very slowly implemented. Therefore, it is the responsibility of all society sectors, including the health sector to maximally decrease GHG emissions where possible. Within the field of anesthesia, the potential to reduce GHG emissions can be briefly summarized as follows: Stop or avoid the use of nitrous oxide (NO) and desflurane, consider the use of total intravenous or local-regional anesthesia, invest in the development of new technologies to minimize volatile anesthetics consumption, scavenging systems, and destruction of waste gas. The improved and sustained awareness of the medical community regarding the climate impact of inhaled anesthetics is mandatory to bring change in the current practice.
吸入麻醉剂已在临床使用超过150年，目前仍在日常实践中广泛应用。多年来，吸入麻醉剂在全身麻醉中不可或缺的最初观点已有所演变，目前其广泛使用甚至受到质疑。除了任何使用中的药物固有的传统风险外，吸入麻醉剂还是极强的温室气体（GHG），可能带来相当大的职业风险。这凸显了评估和考虑其在临床实践中使用的重要性。尽管有大量科学证据表明气候变化正在恶化，但控制措施的实施却非常缓慢。因此，包括卫生部门在内的所有社会部门都有责任在可能的情况下最大限度地减少温室气体排放。在麻醉领域，减少温室气体排放的潜力可简要概括如下：停止或避免使用氧化亚氮（NO）和地氟烷，考虑使用全静脉麻醉或局部区域麻醉，投资开发新技术以尽量减少挥发性麻醉剂的消耗、废气清除系统以及废气销毁。医学界必须提高并持续认识到吸入麻醉剂对气候的影响，才能改变当前的做法。
