Docs suggest reducing anesthesia: Would you suffer to combat climate change?

Experts are now recommending that doctors reduce their use of certain kinds of anesthesia to combat the effects of climate change.

Dr. Mohamed Fayed, a senior anesthetist at Detroit’s Henry Ford Health, made the suggestion during the American Society of Anesthesiologists’ annual conference last Friday in Orlando, Florida. 

“Global warming is affecting our daily life more and more, and the reduction of greenhouse gas emissions has become crucial,” he said.

“No matter how small each effect is, it will add up. As anesthesiologists, we can contribute significantly to this cause by making little changes in our daily practice — such as lowering the flow of anesthetic gas — without affecting patient care.”

Research notes that inhaled anesthesia accounts for up to 0.1 percent of the world’s carbon emissions, which are regarded as the primary driver of global climate change. 

An hour of surgery using as inhaled anesthetic is equivalent to driving as many as 470 miles, according to a 2010 study.

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Most general anesthesia procedures require a high fresh gas flow (FGF) at the start and end of a procedure to quickly achieve the desired effect. But, according to Fayed, it is safe and effective to lower the flow at other times.

Anesthesia must be expertly administered: Too much of a drug can result in brain damage, coma or even death. But too little can mean a patient waking up during the procedure and experiencing intense pain, not to mention trauma.

For their study, researchers from Henry Ford Health dialed down gas flow in an effort to reduce anesthesia use to under 3 liters every minute (L/m) per surgery whenever possible. 

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This effort focused on the use of inhaled anesthetics only — not sedation or localized anesthetics — and produced a substantial decrease in use of the drugs, sometimes by as much as half.

Medical experts at Henry Ford Health also removed the drug desflurane from all operating rooms, noting that it produces the most significant carbon-dioxide emissions.

Data was gathered from 13,000 patients who underwent anesthesia from March 2021 to July 2021. Prior to the intervention, 65% of cases were limited to the 3 L/m threshold. By the end, 93% of cases achieved that.

“For a long time, there was a notion that the greenhouse effect caused in health care settings was an inevitable and unavoidable cost of providing patient care,” said Dr. Fayed.

“But we have learned that reducing anesthetic gas flow is one of the many ways health care can lessen its contribution to the global warming crisis, along with reducing waste, turning off lights and equipment when not in use and challenging practice habits, as long as they don’t compromise patient care.”

The researchers now are aiming to reduce the FGF to less than 2 L/min throughout the system.