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Global Impact: The Environmental Effects of Anesthetic Drugs

Nathan, Naveen MD

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doi: 10.1213/ANE.0000000000005729

In this issue of Anesthesia & Analgesia, a narrative review article describes our current understanding of the environmental impact of volatile anesthetic agents. These commonly used drugs are emitted from hospitals directly into the atmosphere where they harbor heat-retaining and ozone-depleting properties. These effects can lead to global warming. The impact these drugs have represents a small fraction (0.1%) of the total aggregate output of greenhouse gases emitted daily. The majority of culprit gases are comprised of carbon dioxide, methane, and chlorofluorocarbons. That said, there may be measures to directly control this component of greenhouse gas emission. Certain anesthetics such as nitrous oxide and desflurane have longer life spans in the atmosphere compared to other volatile drugs. Methods to reduce anesthetic contribution to climate change would include utilizing low-flow anesthesia, regional techniques as primary anesthetics where appropriate, and carbon filtration or neutralization of gases. These methods also help temper the occupational exposure of health care workers to inhalational anesthetics that the authors discuss. Total intravenous anesthesia may also be considered as an alternative to inhalational gas; however, many intravenous drugs find their way into aquatic reservoirs where they impact aquatic life. The reader is strongly encouraged to read the article in its entirety for a full scope of understanding of these concepts.

    REFERENCE

    1. Varughese S, Ahmed R. Environmental and occupational considerations of anesthesia: a narrative review and update. Anesth Analg. 2021;133:826–835.
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