Quaye Aurora, Karunasiri Charm, Richard Janelle, Arsnow Michael, Montague Robert, Craig Wendy, Wurcel Alysse G
Department of Anesthesiology and Perioperative Medicine, Maine Medical Center, 22 Bramhall St, Portland, ME, 04102, USA.
Division of Anesthesiology, Spectrum Healthcare Partners, 324 Gannett Drive, Suite 200, South Portland, ME, 04106 USA.
Perioper Care Oper Room Manag. 2025 Sep;40. doi: 10.1016/j.pcorm.2025.100518. Epub 2025 Jun 28.
Anesthesia services are a major contributor to healthcare sector greenhouse gas emissions. Interventions aimed to reduce waste are necessary. Reusable anesthesia circuits offer a sustainable alternative to single-use circuits. Their adoption in the United States remains limited. The objective of this project was to evaluate the feasibility, cost-effectiveness, and environmental impact of using FDA-approved reusable anesthesia circuits.
Supported by the SMART QI framework, we evaluated the impact of switching to reusable circuits on elective electroconvulsive therapy (ECT) procedures. We measured waste generation, room preparation times, material costs, and projected system wide financial and greenhouse gas emissions impact. Greenhouse gas emissions were estimated using the Practice Greenhealth Scope 3 Emissions Accounting Tool. Descriptive statistics compared pre- and post-intervention outcomes, with statistical significance at p < 0.05.
We compared 185 ECT procedures: 98 single-use from pre-intervention and 87 reusable circuits from post-intervention. Preparation times did not change. Daily waste from reusable circuits was significantly lower than single-use circuits (99.2g vs. 357.2g, p < 0.001). Cost analysis revealed 40% reduction in median per-case expenditures with reusable circuits ($4.30 vs. $8.50 per patient, p < 0.001).Scope 3 greenhouse gas emissions per procedure decreased nearly 50% (1.09 kgCO vs. 2.57 kgCO, p < 0.001). Modeling of institutional-level data projected an annual cost savings of $108,860 and a reduction of 45,062.4 kgCO if reusable circuits were implemented across all hospitals in the network.
Reusable anesthesia circuits can significantly reduce hospital waste, lower costs, and decrease carbon emissions without compromising procedural efficiency.
麻醉服务是医疗保健部门温室气体排放的主要来源。采取旨在减少浪费的干预措施很有必要。可重复使用的麻醉回路为一次性回路提供了一种可持续的替代方案。它们在美国的采用率仍然有限。本项目的目的是评估使用美国食品药品监督管理局（FDA）批准的可重复使用麻醉回路的可行性、成本效益和环境影响。
在SMART QI框架的支持下，我们评估了改用可重复使用回路对择期电休克治疗（ECT）程序的影响。我们测量了废物产生量、房间准备时间、材料成本，并预测了全系统的财务和温室气体排放影响。使用Practice Greenhealth范围3排放核算工具估算温室气体排放量。描述性统计比较了干预前后的结果，p<0.05具有统计学意义。
我们比较了185例ECT程序：干预前98例使用一次性回路，干预后87例使用可重复使用回路。准备时间没有变化。可重复使用回路的每日废物量明显低于一次性回路（99.2克对357.2克，p<0.001）。成本分析显示，使用可重复使用回路时，每例支出中位数降低了40%（每位患者4.30美元对8.50美元，p<0.001）。每个程序的范围3温室气体排放量减少了近50%（1.09千克二氧化碳对2.57千克二氧化碳，p<0.001）。对机构层面数据的建模预测，如果在网络中的所有医院实施可重复使用回路，每年可节省成本108,860美元，并减少45,062.4千克二氧化碳排放。
可重复使用的麻醉回路可以显著减少医院废物、降低成本并减少碳排放，同时不影响手术效率。
