Anaesthesia
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The sustainable healthcare agenda has become increasingly prominent in recent years. But what does this mean for patients? In this article, we draw on our personal views and experiences as patients, carers and patient advocates, and consider the effects that efforts to improve the sustainability of healthcare may have on care quality and patient experience. ⋯ Based on synthesising these resources with our own experiences, we make recommendations on how to: share information with patients about how they can contribute to healthcare sustainability; offer more sustainable alternatives without pressure; account for diverse patient views on the relevance of sustainable healthcare; provide information about the impact of healthcare on the environment; involve patients and the public in leading positive change; and avoid broadening health inequalities. There is a clear need for more research and engagement to help advance our understanding and weigh up the benefits to individual patients vs. the environmental impacts on the wider population.
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All sectors of society must reduce their carbon footprint to mitigate climate change, and the healthcare community is no exception. This narrative review focuses on the environmental concerns associated with the emissions of volatile anaesthetic agents, some of which are potent greenhouse gases. ⋯ The state of knowledge of the environmental impact and possible climate forcing of emitted volatile anaesthetic agents are reviewed. Additionally, the review discusses how climate metrics can guide mitigation strategies to reduce emissions and suggests present and future options for mitigating the climate impact.
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Observational Study
Reducing the carbon footprint of general anaesthesia: a comparison of total intravenous anaesthesia vs. a mixed anaesthetic strategy in 47,157 adult patients.
Global warming is a major public health concern. Volatile anaesthetics are greenhouse gases that increase the carbon footprint of healthcare. Modelling studies indicate that total intravenous anaesthesia is less carbon intensive than volatile anaesthesia, with equivalent quality of care. ⋯ The carbon dioxide equivalent footprint of hypnotic drugs per intervention in the hospital using the total intravenous anaesthesia strategy was 20 times lower than in the hospital using the mixed strategy (emissions of 2.42 kg vs. 48.85 kg carbon dioxide equivalent per intervention, respectively). The total intravenous anaesthesia strategy significantly reduces the carbon footprint of hypnotic drugs in general anaesthesia in adult patients compared with a mixed strategy. Further research is warranted to assess the risk-benefit ratio of the widespread adoption of total intravenous anaesthesia.