Environmentally Sustainable Anesthesiaand Green Anesthesia
Journal Title: Ελληνικό ηλεκτρονικό Περιοδικό Περιεγχειρητικής Ιατρικής - Year 2019, Vol 18, Issue 0
Abstract
The concept of sustainability in anesthesia, referred as “Environmentally Sustainable Anesthesia”, can be characterized by the safe perioperative management of equipment and medicines by the anesthesiologist, without harming the environment. Τhe term “Green Anesthesia” also relates to the priority to environmental sustainability even if the economic factor comes second, but in essence, sustainable and green anesthesia refer to common actions and practices. The problem of environmental impacts from anesthesiology practice arises when managing chemical agents to ensure the proper conditions for safe anesthesia administration, by pharmaceutical means and special techniques. The main problem is the Inhaled agents (Ν2Ο and volatile anesthetics), as part of them is released into the atmosphere by forming Wasted Anesthetic Gases (WAGs). It begins in the operating room and ends into the atmosphere. Atmosphere is essential for life on earth. WAGs contribute to an increase in the ozone hole [reduction in ozone (O3) concentration in the stratosphere – at ~ 50 km altitude – where ozone has a “shield” role in absorbing the sun’s ultraviolet radiation] and to the greenhouse effect [trapped sun radiation by the atmosphere] which contributes to global warming with its disastrous consequences. There is no evidence to indicate the fate of the waste intravenous agents for sedation and general anesthesia and their metabolic products or any considerable buildup in the food chain. Scavenging system and room ventilation system are the most important factors in reducing WAGs in the operating room, but they don’t protect the atmosphere. The operating room pollution with WAGs is related to the anesthetic technique, inhalation system, scavenging system and any leaks. The basic principles of sustainability, prevention and precaution, are the answer to the problem. The contribution of the anesthesiologist to environmental protection lies in prevention and is implemented through best practices (intravenous anesthesia, regional anesthesia, avoiding less friendly inhaled factors, using low flow anesthesia), mechanical controls and personal protective equipment, both in the operating theatre and in the PACU. Volatile anesthesia is getting more economical and environmentally friendly by recycling of inhalational anesthetics. Xenon, a natural component of the environment with no harmful ecological effect, is an ideal inhaled anesthetic factor, but its limited disposal and its relatively high cost of recovery preclude its widespread clinical use. Eco-consciousness is also associated with the recycling of materials in the operating room and a less noisy environment, as the last one is connected with less stress, better communication and patient safety. The anesthesia community needs to understand how the large number of surgeries performed worldwide daily adds its own burden to the problem of environmental degradation. The point, after realizing, is to find a balance between protecting the patient and protecting the environment, following the basic principles of sustainability. The knowledge that each of us leaves his own imprint on our planet turns inertia into a moral problem.
Authors and Affiliations
Aikaterini Tsirogianni
Keywords
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