Davies Jessica F, Trajceska Ljubiana, Weinberg Laurence
Anaesthesia Department, Austin Health, Heidelberg, Australia.
Department of Critical Care, Melbourne Medical School, University of Melbourne, Melbourne, Australia.
Anaesth Intensive Care. 2023 Mar;51(2):141-148. doi: 10.1177/0310057X221129291. Epub 2023 Jan 31.
Anaesthetic agents have various financial and environmental impacts. Climate change is one of the biggest threats to human health, and anaesthetic gases contribute to global heating by acting as greenhouse gases. The primary aim of this study was to quantify the financial and environmental impacts of anaesthesia maintenance agents used during surgery in an Australian university teaching hospital. The volume of desflurane, sevoflurane, isoflurane and propofol purchased by a university teaching hospital between 2010 and 2020 was analysed and described in terms of financial and environmental impact. Estimated carbon emissions and financial costs of each agent per annum were calculated using the volumes purchased for each agent. A model of ideal anaesthetic agent usage was used to hypothesise the financial and environmental impact of replacing desflurane (the most environmentally damaging and expensive agent) with alternative agents. Using 2019 as an example year at our health service, replacing desflurane with low flow sevoflurane would save greenhouse gas emissions equivalent to driving over 1.4 million kilometres in an average petrol car. Removing desflurane from machines at our institution could save an estimated A$14,630 per annum through reduced machine testing alone. Our findings and calculations indicate that reducing the use of desflurane would have both financial and environmental benefits for healthcare.
麻醉剂具有各种财务和环境影响。气候变化是对人类健康的最大威胁之一,麻醉气体作为温室气体导致全球变暖。本研究的主要目的是量化澳大利亚一所大学教学医院手术期间使用的麻醉维持药物的财务和环境影响。分析并描述了一所大学教学医院在2010年至2020年期间购买的地氟烷、七氟烷、异氟烷和丙泊酚的数量及其财务和环境影响。根据每种药物的购买量计算每年每种药物的估计碳排放量和财务成本。使用理想麻醉剂使用模型来假设用替代药物取代地氟烷(对环境破坏最大且最昂贵的药物)的财务和环境影响。以我们医疗服务机构的2019年为例,用低流量七氟烷取代地氟烷可减少温室气体排放,相当于一辆普通汽油车行驶超过140万公里。仅通过减少机器测试,在我们机构从机器中移除地氟烷每年可节省约14,630澳元。我们的研究结果和计算表明,减少地氟烷的使用对医疗保健具有财务和环境效益。