Lehmann Ferdinand, Mader Johannes, Koch Christian, Markmann Melanie, Leicht Dominik, Sander Michael
Department of Anaesthesiology, Operative Intensive Care Medicine and Pain Therapy, University Hospital of Giessen, Justus-Liebig University Giessen, Giessen, Germany.
Klinik für Anästhesie, operative Intensivmedizin und Schmerztherapie, Krankenhaus im Friedrichshain, Berlin, Germany.
BMC Anesthesiol. 2025 Feb 27;25(1):108. doi: 10.1186/s12871-025-02982-7.
By exceeding planetary environmental boundaries, multiple global crises have become imminent in the 21st century. The healthcare system is a contributor to the climate crisis, accounting for approximately 5% of greenhouse gas emissions in Western countries. In anaesthetic clinics, desflurane, a highly potent greenhouse gas and volatile anaesthetic with no compelling indications, accounts for up to two thirds of total emissions. Its use can be drastically reduced using simple measures. In the present study, we investigated whether a relevant and timely reduction in use could be achieved by dismounting desflurane vaporisers and providing information to the team without restricting its use.
The study was conducted in a German university hospital with approximately 1250 beds, over a 12-month period between 2021 and 2022, with a comparison to the corresponding periods of the previous years up to 2017. The interventions were, first, the removal of desflurane vaporisers, and second, staff education on the climate impact of volatile anaesthetics. The primary outcome variable was the reduction of hypnotic-related emissions in CO equivalents per anaesthetic procedure.
Prospective data collection and interventions were conducted from 28 March 2021 to 27 March 2022. The amount of CO equivalent emissions per procedure in the form of volatile anaesthetics was reduced by 86% compared with the year before the interventions (p < 0.001). Interestingly, there was already a 52.1% reduction in the year before the procedure (p < 0.001). There were no significant changes in the use of sevoflurane or propofol. Hypnotic-related costs decreased by €14,549, whereas extubation time did not change significantly.
Removal of desflurane vaporisers and staff training can quickly and significantly reduce the emissions of an anaesthesia department in a large German teaching hospital. This may also reduce the costs.
The trial was registered with the German Clinical Trials Register, identifier DRKS00024973 on 12/04/2021.
由于超出了地球环境边界，21世纪多种全球危机已迫在眉睫。医疗保健系统是气候危机的促成因素之一，在西方国家约占温室气体排放量的5%。在麻醉诊所，地氟烷是一种强效温室气体和挥发性麻醉剂，在无迫切指征的情况下，其排放量占总排放量的三分之二。通过简单措施可大幅减少其使用。在本研究中，我们调查了通过拆除地氟烷蒸发器并向团队提供信息（而不限制其使用），是否能够实现相关且及时的使用量减少。
该研究在一家拥有约1250张床位的德国大学医院进行，时间跨度为2021年至2022年的12个月期间，并与2017年之前的前几年同期进行比较。干预措施一是拆除地氟烷蒸发器，二是对工作人员进行挥发性麻醉剂对气候影响的培训。主要结果变量是每次麻醉手术中与催眠相关的二氧化碳当量排放量的减少。
前瞻性数据收集和干预措施于2021年3月28日至2022年3月27日进行。与干预前一年相比，挥发性麻醉剂形式的每次手术二氧化碳当量排放量减少了86%（p < 0.001）。有趣的是，在手术前一年排放量就已经减少了52.1%（p < 0.001）。七氟烷或丙泊酚的使用没有显著变化。与催眠相关的成本降低了14,549欧元，而拔管时间没有显著变化。
拆除地氟烷蒸发器和对工作人员进行培训可迅速且显著减少德国一家大型教学医院麻醉科的排放量。这也可能降低成本。
该试验于2021年4月12日在德国临床试验注册中心注册，标识符为DRKS00024973。
