Health cares’ impacts – True costs of anesthetic gases

Main Presenter:    Amelie Michalke 

Co-Authors:   Sandra Köhler     Lukas Messmann      Stephan Knigge      Sebastian Gibb                              

Climate change is already harming human health and is expected to have even more serious consequences in the future. It is considered the most significant global health threat of the 21st century. Every part of society, including the health sector, needs to adjust its actions and plans to match the goals of the Paris Agreement. A significant contributor to healthcare’s climate impact is the use of anesthesia gases, potent greenhouse gases with substantial global warming potentials. Commonly employed anesthetics like nitrous oxide and fluorinated gases—sevoflurane, isoflurane, and desflurane—significantly contribute to the health sector’s carbon footprint. These gases, with global warming potentials ranging from 130 kgCO2e/kg (sevoflurane) to 2540 kgCO2e/kg (desflurane), are currently released into the atmosphere. This study investigates options to reduce the climate impact of anesthetic gases with a comparative LCA on intravenous anesthesia vs. inhaled anesthesia. In detail, we assess
impacts of commonly used intravenous anesthesia —sevoflurane, isoflurane, and desflurane—in comparison to intravenous propofol. Our investigation estimates the entire carbon footprint generated by these agents, spanning from the manufacturing of raw materials to the emissions of anesthetic gases during the use phase while also considering the influence of anesthetic gas filters. In comparison to previous studies, we address concerns regarding the assumed doses for intravenous anesthesia (propofol, 100 mcg/kg/h instead of 4-6 mg/kg/h), the density of the drug used for inhaled anesthesia (sevoflurane), and the fresh gas flow (0.3 l/min instead of 0.5 l/min). Additionally, based on results from the LCA results, we calculate the resulting environmental costs from use and consequential emissions of anesthetic gases. With the approach of True Cost Accounting (TCA), we monetize the resulting LCA impact and therefore describe the damage costs incurred through its use. This study provides a
nuanced understanding of the environmental and economic impact of anesthetic gases, contributing to the broader discourse on sustainable healthcare practices.

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