Guest essay by Eric Worrall
The Hospital for Special Surgery in New York is apparently cutting back on use of general anaesthesia for hip and knee replacement surgery, to minimise the impact of surgical procedures on global warming.
Gases used to knock patients out before they go under the knife are ‘fuelling climate change’ and should be replaced with ‘regional’ anaesthetics, scientists claim
…
By JONATHAN CHADWICK FOR MAILONLINE
PUBLISHED: 08:30 AEST, 17 June 2020 | UPDATED: 08:30 AEST, 17 June 2020
Switching from general to regional anaesthetics may help cut greenhouse emissions and ultimately help reduce global warming, a new study claims.
While regional anaesthetics numb a certain part of the body, general anaesthetics make patients totally unconscious for what tend to be more serious procedures.
But unlike regional anaesthetics, generals use volatile and environmentally-unfriendly halogenated agents, such as desflurane, or nitrous oxide.
…
‘Following general anesthetics, volatile halogenated agents and nitrous oxide are exhaled by the patient and are also often scavenged from the operating room and released into the atmosphere,’ the research team say in Regional Anesthesia & Pain Medicine.
‘Very little – less than 5 per cent – of the volatile halogenated gases used during general anesthesia is metabolised by the patient.
‘The remainder is eventually vented into the atmosphere, and although each volatile gas used in anesthesia does differ in its global warming potential, all have some contribution to climate change.
…
The Hospital for Special Surgery in New York therefore opted to carry out as many hip and knee replacements as possible using regional anaesthesia in 2019.
…
Read more: https://www.dailymail.co.uk/sciencetech/article-8427763/General-anaesthetics-fuel-climate-change-scientists-warn.html
The abstract of the study;
‘Green-gional’ anesthesia: the non-polluting benefits of regional anesthesia to decrease greenhouse gases and attenuate climate change
Mausam Kuvadia, Cynthia Eden Cummis, Gregory Liguori and Christopher L Wu
Volatile halogenated gases and nitrous oxide used as part of a balanced general anesthetic may contribute to global warming. By avoiding volatile inhalational agent use, regional anesthesia may reduce greenhouse gas emissions and help prevent global warming. We present a theoretical calculation of the potential benefits and a real-life example of how much regional anesthesia may reduce greenhouse gas emissions.
Read more: https://rapm.bmj.com/content/early/2020/05/06/rapm-2020-101452
I’m a bit uncomfortable with the idea of climate change being used as a criterion for patient care decisions. Doctors should focus on what is best for the patient, not on what they think the weather will be like a hundred years from now.
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‘unlike regional anaesthetics, generals use volatile and environmentally-unfriendly halogenated agents, such as desflurane, or nitrous oxide. ‘
saved by a comma?
Let’s just go back to Napoleonic times when you got a few swigs of whiskey and bit on a bullet when they amputated your leg. Much more “environmentally friendly”.
Builds character as well.
Sorry, lead’s bad for the environment, too – no bullet for you!
Here, bite down on this piece of dried tofu.
What about a silver bullet?
Try that on me, and I promise these wingnuts I will puke right in their faces. They should get it first. I won’t clean up after them, either.
Hip joint replacement with a regional anesthetic? I can envision a lot of stomach contents on the floor of the OR. Let’s just go back to the mid-19th century, when a bottle of whiskey was about all the anesthetic a patient got, if that.
Just curious: are they going to also demand that we ingest mold instead of penicillin or any of its derivatives? Should we just skip vaccinations and go to epidemics and plagues again? I mean, why not? If it takes those bozos out first, and the rest of us just watch, I’m all for it. /sarc
I have had two hip replacements done under local anesthesia (lower body). No problem – no pain…
Gregory Woods
Albeit too late for you, this appears to be the future, and I would happily have it done under a local. Might have to listen to AC/DC through my headphones though, the ‘scraping’ might get to me a bit. 🙂
https://www.imperial.nhs.uk/about-us/news/new-hip-resurfacing-implant
Sara
Full Hip replacements are hopefully a thing of the past.
And, yes, my GP has referred me for this rather than have a rather large piece of my leg replaced!
https://www.imperial.nhs.uk/about-us/news/new-hip-resurfacing-implant
Nitrous oxide is also used in dental work, obstetrics and for analgesia for minor injury manipulation; the reason being it is quickly cleared from the body once the mask is removed from the face. Halane is used for deeper anaesthesia. The alternatives, ether and chloroform are dangerous for the patient and may also be “green house gases”.
We are being dragged back to pre industrial times with low CO2 and amputations being undertaken in 10 seconds without anaesthesia depending on alcohol to dull the pain.
Nitrous oxide is also used as the pressurant/propellant for expelling “whipped” dairy cream from those convenient flex-nozzle canisters sold in grocery stores . . . soon to be disappearing in order to save planet Earth.
Still? I thought nitrous oxide was phased out of food products decades ago.
gotta be THE dumbest product anyway
real cream whips fast and its not hard to pipe if you really have to
can stuff is additive central and a waste of money
and?
no one gets to lick the bowl or spoon;-(
And most importantly! When I whip my own cream … I get to control the amount of sugar added to the cream (I like a very light touch of sugar … very light). I always whip my own. No cans, plastic packaging and whatnot.
they were on about this years ago
bloody idiocy because mst adult surgery is done with injectable anaesthesia
why?
because they dont like to talk about it but theres hefty later risks apparently, carcinogen etc
oddly they still use inhalables for kids..
and a curious factoid?
it appears that quite a lot of A FIB cases apear within a month or 3 of surgery
mine hit me almost exactly 4 weeks after surgery, and it took a year o r more browsing medical pages on afib to find it out. unfunnier still is to try n get some ease from afib?
surgery and ablation;-/
result for me was lessened events but not “cured”
so upshot would be if at all possible but NOT for goofball climate reasons local injectables arent a bad way to go as an option.
The quantities of N2O cannot be anything else than negligible in view of total emissions, even in view of the CO2 emissions of the very patient during his hospitalization, N20 in the atmosphere is mainly a decay product of fertilizers plant decay caprolactam (nylon) production nitrous acid plants etc. It is not specifically to be made for medical purposes. I recon just captured before emission and maybe purified. As for the halogenated agents, the quantity should be equally negligible considering that in the 80-ies more than 1 kilogram of the stuff per capita per annum was sprayed. I think there are other areas where emissions can be cut more easily and more efficiently.
100% nitrogen eliminates all pain and is not a halogenated agent or nitrous oxide.
+100
Just when I thought they couldn’t come up with anything dumber….
I have even a better solution: a good hit with a shovel to the back of the head.
Ding ding ding
Makes more of a “clang” when used on a green “activist” head. (No, I do not have absolute proof of this, but that is the sound made when you whack a chunk of concrete.)
My thoughts are that it would have a hollow tone.
If only there were really catastrophic climate change really on its way, this marked virtue signaling would be so very, very admirable!
Don’t forget the first local anaesthetic was cocaine. Heroin used as a cough suppressant.
This is evidence of the beginning of the end of climate scare combinations or the NY virus has mutated again.
Yes, let’s stop single use plastics in medicine while we’re at it. There just seems to be no end of stupid gets klimate funding and publication.
No, let’s not base patient care on climate- at the very least until we could actually have an adult conversation about climate and admit that models are currently vastly over rated and biased to AGW, and they could begin to hindcast climate change. Oh and that AGW is a political invention and we need to move on to reality.
I’ll hold my breath for that level of adult dialogue (sarc).
Enviros have no sense of scale.
Building pictures was where Jason Bourne jumped into river in ‘The Bourne Ultimatum’ 2007.
The current advise in the UK, Knee replacement surgery is usually performed either under general anaesthetic (you’re asleep throughout the procedure) or under spinal anaesthetic or epidural (you’re awake but have no feeling from the waist down). No mention of local anaesthetic I surpose it’s down to a patient’s individual needs.
I had major surgery in 2019 I had epidural but was out completely, the benefit of general anaesthetic is pain can be controlled after the op ,in my case 5 days.
Another climate issue in medicine is inhalers, they have become increasingly powders rather than using a propellant, I have complained many a time that because you cant inhale as well as you used too ,your not getting the full dose, the last time was 2 weeks ago, I had a phone consultation, were the doctor changed the prescription to a propellant inhaler, picked the prescription up Monday I did have a new inhaler but it was still a powder one. The doctor in the consultation assured me it would be a propellant type, lied to again in the name of the climate.
Eventually the climate sensitivity of carbon dioxide will be found to be zero, or indistinguishable from zero. The sooner the better. Then the global warming potential – calculated as a multiple of that for carbon dioxide – of all the other greenhouse gases must also be zero.
To illustrate the point, consider the graph at this link, in which I plot the “vertical integral of total energy,” expressed as Watt-hours, at a single gridpoint near where I live. This is from the reanalysis product ERA5 from the ECMWF, for every hour of 2019. The doubling of CO2 from preindustrial times is commonly accepted to have a static warming effect of 3.7 W/m^2, or 3.7 Watt-hours per hour per m^2. That is vanishingly thin on the vertical scale, and the magnitude of the rapid changes in both directions tells me that any effect of rising CO2 concentrations would be undetectable. Energy is easily transformed from latent heat to kinetic energy to potential energy to sensible heat and back again, so it is simply bonkers (a technical term) to claim that carbon dioxide has been found to be the cause of a trend or to claim that it can be modeled so as to project a future trend.
The climate sensitivity of CO2 has already been found to be zero. https://watervaporandwarming.blogspot.com
Interesting sites Dan
Regards
An important new paper by Richard Lindzen igonored on WUWT.
WUWT?
https://link.springer.com/article/10.1140/epjp/s13360-020-00471-z
It would at least be a break from the endless recycled moronic mind-rotting media agitprop.
It’s a drip-feed of Kafka-esque corrosive nonsense that’s designed to psycologically destabilise right-thinking citizens, and recycling it helps in that process.
Realise that they are only screwing with your mind and just laugh it off.
The Khmer-Vert Luddites are aiming for another pillar of the industrial scientific revolution – anaesthesia.
For them the agenda is back to the jungle. Human population back to <100 million, life expectancy back to 20.
Oh, our leaders will still have access to the blessings of technology, don’t you worry.
When a Green has to be under the knife, why not a strong punch on the chin, may be two if the first wasn’t strong enough, and go on.
To discuss anaesthetics because of “climate change” asks just such a solution for such morons.
SCNR 😀
Idiotic just from the headline.
The surgeons could go back to just hitting the patient on the head with a mallet or getting them stinking drunk. That would really save on harmful gases, would it not? Possibly patient care and survival would suffer, but do we care about such mundane matters any more, in the Age of Stupid?
Better yet add leaches after the mallet
From the article: “Switching from general to regional anaesthetics may help cut greenhouse emissions and ultimately help reduce global warming, a new study claims.”
How absurd! It just keeps getting crazier and crazier. Alarmists have lost their minds.
Surely we must be reaching the point where even the dumbest, most gullible greenie will say:
“Wait a minute.. that just can’t be true..”
Surely, you jest…
I’m not jesting and don’t call me Shirley!
Wow! We used lots of nitrous oxide over the years for in office sedation. That was before global warming (back in the 80’s and early 90’s) /sarc. Also we used Versed and fentanyl for IV sedation. Lots of addicts now(just kidding). All GA’s done in a surgicenter of hospital. Lots of gas passed. Anesthiology is 99% boredom and 1% panic as my anesthesiologist used to joke. A joke just like this article.
Well, parakeets also breathe out CO2, so maybe if we kill all the parakeets, people that need knee surgeries can have them without resorting to booze and leather to endure the pain…
Are there any surgeons on this list care to comment?
I was under the impression that general anesthesia was done using only drugs supplied intra-venously these days. But then medicine is not my area of expertise, so what do I know? What’s the real answer?
Ding ding doing! When my wife had a c-section four years ago, I sat next to her and the anesthesiologist sat on the other side of her. He had a syringe s rewed into the IV line and was slowly (as in, another mL every few minutes) injecting her with it. The days of teasing the anesthesiologist as a “gas passer” appear to be over.
correct as I wrote above
IV can also be reversed fast if needed too
inhaleds not so much
I travel a lot further to a vet who uses IV when my local young lasses insist on inhaleds for every procedure they do
also a HUGE cost icrese in inhaled over IV
so Id say that would be the BIGGIE for the hosp
saying green
but meaning greenbacks
This is a very useful paper. I now know where NOT to go for surgery. I wouldn’t let anyone who puts the “environment” ahead of patient comfort and safety get near me with any sharp implement, not even a nose-hair-trimmer.
Since I had both knees replaced 5 years ago I’m for the old bite the bullet because the infinitesimal amount of some gas being released that will break down in no time out weights the pain caused by not being properly sedated. Just when I don’t think these people can get any stupider they go and prove me wrong.
I think this must be a cover for trying to reduce their patient load. You would have to be seriously masochistic to want surgery from this mob.