Department of Anaesthesia, Wollongong Hospital, Wollongong, NSW, Australia.
Graduate School of Medicine, University of Wollongong, NSW, Australia.
Anaesthesia. 2022 Sep;77(9):1023-1029. doi: 10.1111/anae.15785. Epub 2022 Jun 21.
Climate change is a real and accelerating existential danger. Urgent action is required to halt its progression, and everyone can contribute. Pollution mitigation represents an important opportunity for much needed leadership from the health community, addressing a threat that will directly and seriously impact the health and well-being of current and future generations. Inhalational anaesthetics are a significant contributor to healthcare-related greenhouse gas emissions and minimising their climate impact represents a meaningful and achievable intervention. A challenge exists in translating well-established knowledge about inhalational anaesthetic pollution into practical action. CODA is a medical education and health promotion charity that aims to deliver climate action-oriented recommendations, supported by useful resources and success stories. The CODA-hosted platform is designed to maximise engagement of the global healthcare community and draws upon diverse experiences to develop global solutions and accelerate action. The action guidance for addressing pollution from inhalational anaesthetics is the subject of this article. These are practical, evidence-based actions that can be undertaken to reduce the impact of pollution from inhalational anaesthetics, without compromising patient care and include: removal of desflurane from drug formularies; decommissioning central nitrous oxide piping; avoidance of nitrous oxide use; minimising fresh gas flows during anaesthesia; and prioritising total intravenous anaesthesia and regional anaesthesia when clinically safe to do so. Guidance on how to educate, implement, measure and review progress on these mitigation actions is provided, along with means to share successes and contribute to the essential, global transition towards environmentally sustainable anaesthesia.
气候变化是一种真实且正在加速的生存威胁。需要采取紧急行动来阻止其发展,每个人都可以做出贡献。减少污染是卫生界发挥急需领导力的重要机会,可以解决直接严重影响当前和未来几代人健康和福祉的威胁。吸入性麻醉剂是医疗保健相关温室气体排放的重要贡献者,最大限度地减少其气候影响代表了一种有意义且可实现的干预措施。将关于吸入性麻醉剂污染的既定知识转化为实际行动存在挑战。CODA 是一家医学教育和健康促进慈善机构,旨在提供以气候行动为导向的建议,并提供有用的资源和成功案例的支持。CODA 托管的平台旨在最大限度地提高全球医疗保健界的参与度,并借鉴各种经验来制定全球解决方案并加速行动。本文介绍了解决吸入性麻醉剂污染问题的行动指南。这些是实际的、基于证据的行动,可以采取这些行动来减少吸入性麻醉剂污染的影响,同时又不会影响患者的护理,并包括:从药物配方中去除地氟醚;停用中央一氧化二氮管道;避免使用一氧化二氮;在麻醉期间尽量减少新鲜气流;在临床安全的情况下优先考虑全静脉麻醉和区域麻醉。还提供了关于如何教育、实施、衡量和审查这些缓解行动进展的指导,以及分享成功经验和为向环境可持续的麻醉过渡做出贡献的方法。