Greening the operating room, one procedure at a time

• Main Authors: Shital D. Patel, MD, Rachel Smith-Steinert, CRNA
• Format: Article
• Language: English
• Published: Elsevier 2021-05-01
• Series: The Journal of Climate Change and Health
• Subjects: Sustainability; Inhalational agent; Global warming potential; Greenhouse gas; Carbon footprint
• Online Access: http://www.sciencedirect.com/science/article/pii/S2667278221000122

Background/Purpose: There is growing interest within the anesthesia community regarding sustainability practices. A quality improvement initiative at a large, urban, academic medical center provided anesthesia practitioners education to promote change in practice to reduce our overall carbon footprint in the operating room. This endeavor provided cost-savings to the healthcare system and positioned the anesthesia department as environmental advocates. Methods: Institutional Review Board approval was granted for non-human subject research. A retrospective chart review was completed examining inhalational agent usage and fresh gas flow rate over thirty days (n = 304). Next, an education on sustainability practices with an overview of inhaled anesthetics and their impact on the environment, based on global warming potential, was delivered during department grand rounds. Afterwards, data was collected for 30 days with the same sampling technique (n = 285). Six weeks later, desflurane vaporizers were removed from anesthesia machines. After removal, data was collected once again to determine desflurane usage (n = 289). Results: A retrospective chart review of 878 patients undergoing general anesthesia showed an average baseline usage of desflurane at 8.3%. A reduction to 3% was noted after implementation of sustainability education. Desflurane usage further decreased to 0.3% after desflurane vaporizer removal. Discussion: This quality improvement initiative resulted in cost savings and provided a significant environmental impact while providing the tools for a conscious, deliberate decision in care based on current literature to decrease global warming impact while preserving the practitioners right to choose an inhalational agent.