Climate Change – Is It Time to Say Goodbye to Inhaled Anaesthesia?

[I can’t even…charles]

Inhaled anaesthetic gases are potent greenhouse gases, with effects up to thousands of times more potent than carbon dioxide; • In most cases, there is no reason why intravenous or regional anaesthesia cannot be safely used in its place

Reports and Proceedings


A review presented at this year’s Euroanaesthesia Congress will address the environmental impact of inhaled anaesthetic agents and how we can and should manage without them – or at least massively reduce their use. The presentation will be given by anaesthesiologist Dr Niek Sperna Weiland, Amsterdam University Medical Center, The Netherlands, founder of the centre’s Sustainable Healthcare Team.

All volatile (gaseous) anaesthetics are potent greenhouse gases, ranging in global warming potential (GWP) from 440 to 6810 relative to carbon dioxide (CO2,) which has a reference GWP of 1.  The anaesthetic sevoflurane has a GWP of 440, isoflurane 1800, and desflurane 6810. These are all extremely high. Methane, emitted by livestock around the world and other processes, has a GWP of 86, and Nitrous oxide (emitted by agriculture, but also used in anaesthesia) is 289, and this gas has an extremely long atmospheric lifetime (around 120 years).

“Reduction of emission of these gases is a quick win in combatting climate change,” explains Dr Sperna Weiland. “After use, these substances are emitted into the atmosphere and rising concentrations have been registered even in very remote areas such as Antarctica and high in the Alps.”

There are several ways to reduce emissions, which include ending the use of nitrous oxide, desflurane and isoflurane immediately, though a combination of efficient use of the only other available alternative (sevoflurane), and switching to other modes of anaesthesia such as TIVA (total intravenous anaesthesia) and regional anaesthesia (spinal/epidural/nerve blocks); and also capturing volatile anaesthetics from the exhaust air piping. “It is also hopeful that a complete ban on desflurane is now being prepared by the European Commission*, which would come into effect on 1 January, 2026,” explains Dr Sperna Weiland.

He will explain that while some indications for inhaled anaesthesia will remain, there is no reason why a patient could not be switched to TIVA or regional anaesthesia in most instances. “There is no evidence that volatile anaesthesia results in more favourable patient outcomes. That said, we cannot do entirely without these inhaled agents. The most common indication may be the continued need for mask induction of anaesthesia for children,”

He will also present the successful sevoflurane reduction campaign of Amsterdam UMC, which has seen annual cannisters used fall by 70% from above 2500 per year to below 1000. In line with previous recommendations, Amsterdam UMC also completely abolished nitrous oxide, desflurane and isoflurane.

This success has come without the hospital yet implementing capture and recycle technology. He explains: “In Amsterdam, we do not capture and recycle and yet we reduced our emissions by 70%. This seems almost as low as you can go with using sevoflurane efficiently and switching to regional/TIVA. For the remaining 30%, capture and recycling will be the only option. While technology that can do this is coming onto the market, there are some legal issues with marketing the recycled substance which must still be overcome before this can become widespread practice.”

Dr Sperna Weiland will address overall energy use in operating rooms (ORs), explaining “hospitals generally do not seem to have any clear policy on this, and indeed energy saving technology only tends to be introduced when operating theatres are refurbished, or entirely new hospitals are built. But as we ourselves have demonstrated, you really can save a lot of energy by switching off most ORs during evenings, through the night and over weekends. In Amsterdam, we save around 360.000 kWh per annum by doing this”.

For waste materials, Amsterdam UMC uses the apply the ‘reduce, reuse, recycle’ paradigm. A lot of the materials in ORs are disposed of unused, just because it was unwrapped due to protocol. Dr Sperna Weiland explains: “We are critically reviewing these protocols and also the sets that we use. Moreover, we have developed a washable surgical headcover that is being implemented this year. We will go from 100,000 disposable headcovers to just 500 per year, and save around 60% of our carbon footprint for headcover use. Lastly, we implemented a full recycling program of plastic packaging materials on all our operating rooms recycling around 4000 kg per month.”

He concludes: “Climate change has really come to the top of the agenda in many countries, in both developed and developing countries, especially in the last couple of years. Every sector must play its part in reducing both emission of harmful gases and overall energy use. It is clear that much can be achieved with relatively little effort, such massively reducing use of inhaled anaesthesia and general power saving techniques. Some national and international policies may be required to target remaining emissions, especially those associated with our supply chain, but at Amsterdam UMC we have shown what is possible with our own effort first.”

Dr Niek Sperna Weiland, University Medical Centre Amsterdam, The Netherlands. Please e-mail with questions and interview requests. E)

Alternative contact in the Euroanaesthesia Media Centre. Tony Kirby of Tony Kirby PR. T) +44 7834 385827 E)

Notes to editors

Dr Sperna Weiland declares no conflict of interest

This press release is based on a presentation at Euroanaesthesia 2022 in Milan, 13ME1 Reducing the carbon footprint of anaesthetics, at 1630H Milan time in room Amber 7 on Saturday 4 June.

As it is an oral presenation there is no abstract.

*Desflurane ban information: planned date January 1 2026. Reference:, see page 24.

From EurekAlert!

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June 4, 2022 6:03 am

The industrial healthcare complex seems to have become a terrorist organization.

Reply to  Scissor
June 4, 2022 6:55 am

It does have strange priorities.

Leave the OR out of it. Many, many more people are what we in the UK call ‘outpatients’, people who go for an appointment at a clinic or for tests etc Consider all of the plastic packaging and products that a health system uses, from drips to syringes to sterile packaging etc.  

“…new and highly intensive drug treatments with large carbon footprints – begin to look as unsustainable as flying to New York for a long weekend. “,4C1N8,FMBAYN,FVU4H,1

None of the NHS blurb on emissions and Carbon footprints mentions plastic at all and I’d say they use far more plastics than most. The NHS is huge.

“To understand how and when the NHS can reach net zero we established an NHS Net Zero Expert Panel, reviewed nearly 600 pieces of evidence submitted to us and conducted extensive analysis and modelling.”

More [useless] modelling. 

Dave Andrews
Reply to  fretslider
June 4, 2022 9:03 am

In the past before the use of single use plastics medical equipment and supplies had to be sterilised, either on site or in centralised units and cross contamination was a considerable problem. Single use plastics largely eliminated this problem.

Reply to  Dave Andrews
June 4, 2022 9:23 am

Maybe it’s boom times for makers of autoclaves?

Reply to  Dave Andrews
June 5, 2022 1:45 am

small benchtop autoclaves work fine, Id hazard a guess its the centralized huge setups where the issues come from?

Reply to  ozspeaksup
June 6, 2022 1:43 am

Autoclaves use no electricity? I don’t know but I’d wager they use a whole lot more than it takes to make a single-use plastic item.

Gary Pearse
Reply to  Scissor
June 4, 2022 10:45 am

There is no end to this without ridding ourselves of the Great Reset ghouls and virtually every Western country leader. Why did they not think of stopping use of the best anesthetics before? Well it’s because they have progressively learned that there is no limit to what we will put up with. The have the data on how easily managed we are. Not enough fertilizers because of draconian gov policies? Well let the population die back to make supply meet demand!

The only action that seems to be interrupting the march of an Armageddon of idiots in the West is Russia’s invasion of Ukraine! This has dealt what appears to be a terminal blow to further development of renewables. It has bared the soft underbelly of renewables – the indispensable need for fossil fuels to to “back up” renewables for everyone to see!

June 4, 2022 6:08 am

Is it Time to Say Goodbye to Inhaled Anaesthesia?
Yes, yes, and yes.This is a great way to make people suffer even more.
Injected pain killers and anesthetics will be seen as “loopholes”.Of course, politicians just have to “Close The Loopholes”. So those medical treatments will be banned as well. They want you to suffer.

For your own good, of course.

YouReekAlerts: Off the rails as usual.

Dr. Bob
June 4, 2022 6:13 am

There are so many examples of situations like this.
We take showers in a potent GHG all the time and with quantities of that substance that are known to be toxic to humans and could cause drowning. But we ignore it.
We burn a potent GHG just for fun in decorative lamps and fire pits in way too many places with no effect other than visual impact and yet no one has said a word about stopping that practice. (Decorative fire pits and NG lanterns in case you didn’t get the reference.)
We should have stopped that practice in the 1990’s when this GHG issue first became cause celeb. But no one even thinks about them. So. the problem must not be real. Or so one would think. This list goes on and on including banning recreational driving and other energy consuming activities. We should be banning TV and Movies as they serve no useful prupose and consume much energy (including much NG for fake fires just to film a disaster or two.)
I could ramble on, but you get the point.

Reply to  Dr. Bob
June 4, 2022 7:47 am

Remember, firepits, fireplaces and wood stoves emit bad GHGs. But biofule/woodchips for electric generation is acceptable.

Reply to  Geo
June 4, 2022 8:05 am

I think lamposts may find uses that reduce some people’s GHG emissions.

joe x
Reply to  Scissor
June 4, 2022 10:37 am

i get it and agree.

william Johnston
Reply to  Scissor
June 4, 2022 2:25 pm

Subtle but effective.

Reply to  william Johnston
June 5, 2022 1:50 am

and hemp rope is so natural and reuseable too;-)

Reply to  Dr. Bob
June 4, 2022 8:23 am

For example, a recent EPA regulation has made the cost of the most common refrigerant, r410a, explode by a factor of 10 as a result of its irrelevant GWP score. Phasing it out for new systems to avoid a few parts per billion of HFC in the atmosphere is bad enough, but artificially restricting its supply is as stupid as it gets as all it does is contribute to inflation by increasing the price without lowering demand. Just like with gasoline, these idiots think that artificially raising the price of a commodity that has no viable substitute has any significant effect on demand. Only the poor will be forced to cut back because they have no choice between fixing their AC or filling their gas tank and buying food.

Reply to  Dr. Bob
June 5, 2022 1:48 am

greenies in aus started a hate on gas campaign last year. pushing the 2.5particulate and asthmas etc they want to ban gas heaters stoves etc funny after huge campaigns to run all water heaters to be gas not electric
Aus is THE largest LPG exporter were supplying everyone else and running short at home
almost bidenesque here ATM

June 4, 2022 6:25 am

I’m guessing chloroform is a no-no – it too has a global warming potential. And ether is obviously a no-no.

So, we’re left with the old 17th century anaesthetic: alcohol. But is that green enough?

“As a rule of thumb, the higher the alcoholic content of a drink, the higher the carbon footprint per litre.”

That statement is utter rubbish and I’m sure they know it.

“It’s not just a bad hangover – this is how alcohol affects the environment”

Oh well, there’s always the original way – biting on something while being held down.

D. McCann
Reply to  fretslider
June 4, 2022 12:27 pm

But no biting the bullet. Those too will be banned.

Tom Halla
June 4, 2022 6:26 am

I do think the doctor in question should be investigated for depraved indifference to patient welfare, as virtue signalling on climate change is evidently a much greater concern for her.

Alexy Scherbakoff
Reply to  Tom Halla
June 4, 2022 6:08 pm

He’s from the school of ‘the operation was a success but unfortunately, the patient died’.

Ron Long
June 4, 2022 6:46 am

Let’s have these Greenie Doctors try a shot of whiskey and a leather belt between their teeth and see how they like it. Would make a great video (not for children and sensitive viewers).

Gordon A. Dressler
Reply to  Ron Long
June 4, 2022 7:11 am

One would think that medical doctors would know all about relative percentages (aka concentrations). After all, many medications are prescribed on the basis of total body weight of a patient, and results of such even monitored on the basis micrograms/liter (or equivalent) detected in blood or urine.

Therefore, it was very surprising the see this as the very first statement in the above article:
“Inhaled anaesthetic gases are potent greenhouse gases, with effects up to thousands of times more potent than carbon dioxide.”

If one considers the “patient” as being Earth’s atmosphere, that sentence should have been extended with something along the lines of the following clarification:
“. . . , but in reality they are used so sparingly around the planet that they contribute less than .00001 percent of the greenhouse gas effect compared to existing atmospheric CO2 levels of 420 ppm.

Bottom line: much ado about nothing

June 4, 2022 7:03 am

“In most cases, there is no reason why intravenous or regional anaesthesia cannot be safely used in its place”

I’m no physician but this former SF medic that has administered general anesthesia, spinal blocks, and even local blocks for removing ingrown toe nails on big toes calls thinks this statement is very misleading.

Local or regional blocks are great for many surgeries on extermities but when you start working on heart and lungs and other major internal organs you want the full and much quicker control of the level of consiousness of the patient that general anesthesia provides. Even on serious deep surgeries on extremities a general has always been indicated to help prevent shock and to be sure the patient remains still during the proceedure.

I’m thinking these crazy MFers are going to be recomending the patient just gets Laudlim and a bite stick for an amputation sooner or later! My answer is, YOU FIRST!

Reply to  rah
June 4, 2022 7:24 am

Sorry I meant Laudanum

Richard Page
Reply to  rah
June 4, 2022 8:06 am

Laudunum? No, I don’t think so. Obviously the only way forward is to ban all drug based anaesthetics and go with full hypnotherapy instead – far more beneficial for the environment. sarc (no, really!)

Tom in Florida
Reply to  rah
June 4, 2022 11:03 am

Perhaps getting rid of hospitals in general is better. Think of all the power savings without any hospitals to use it 24/7. Witch doctors, medicine men, and pushers of magic elixirs will all benefit.

Reply to  rah
June 4, 2022 2:27 pm

I’ve had an aortic valve replacement, they used TIVA. The last thing I remember is a discussion of Margarita recipes with the surgeon, then waking up 4 hours later, still high, laughing and telling jokes.
The strongest pain medication they gave me was Tylenol…

william Johnston
Reply to  rah
June 4, 2022 2:31 pm

I watched a tv show once where the surgeon came in, in a 3-piece suit, patient had been administered laudanum, proceeded to amputate the patients leg. This was in a classroom setting. A teaching venue. Patient self-anesthetized. Passed out!!!! Along with several members of the observng galley.

June 4, 2022 7:23 am

The Global Warming Potential Number (GWP) that appears in all the IPCC reports is a convoluted scheme designed to produce a large but meaningless number. 

A Piper Cub will fly 86 times further on a gallon of gas than a Jumbo Jet. The proper response is, “So What?” The same is true for a GWP of 86 for methane, “So What?” 

The GWP numbers ranging from 440 to 6810 for anesthetic gas are also meaningless and deserving of a “So What?” response. 

Note that nowhere does it ever say how much methane or these medical gases will actually increase global temperatures. We aren’t told because they won’t.

The GWP nonsense needs to be exposed.  

Reply to  Steve Case
June 4, 2022 7:41 am

At the same time, it’s easier to get fentanyl than baby formula.

Reply to  Scissor
June 4, 2022 9:00 am

In the UK there’s a shortage of HRT for women.

“Data from NHS England shows that prescriptions for HRT have more than doubled in over the past five years.”

What explains a doubling over 5 years? Can you guess?

I’m amazed that the US has gone full Ayn Rand on baby formula.

Reply to  fretslider
June 4, 2022 9:52 am

If it’s man boobs one wants, marijuana is medically legalized in 38 U.S. states and in 19 for any use.

Reply to  fretslider
June 5, 2022 1:57 am

usa knew thered be shortages well beforehand and they could have given the OK to Aussie baby formulas our GMP and setups are as good maybe better? and we have plenty as the chinese dont have their personal shoppers sending containers full back home, as they were pre covid

Reply to  fretslider
June 5, 2022 1:59 am

shortages of the injectable diabtes meds in aus and uk etc too cos the tiktokers spread the word to use offlabel for weight loss, 1kg a week seems to be the expected result
of course the prominent warning about possibly a oesophageal/throat cancer causant gets ignored

oeman 50
Reply to  Steve Case
June 4, 2022 8:25 am

I do not see that the article indicates how much total global warming potential these substances contribute. They just say it is X number of times more than CO2 per molecule and can be detected in Antarctica and the Alps. Who cares? (I don’t.) I surmise by the way this is described, it has very little impact and what we have, again, is major virtue signaling.

Mark BLR
Reply to  Steve Case
June 4, 2022 8:36 am

The same is true for a GWP of 86 for methane,

You appear to be using an “obsolete” value there.

The “latest and greatest” AR6 (WG1) report has updated numbers in Table 7.15 (on page 1017).

You will note that the “evil, anthropogenic” — or “fossil” — CH4 molecule has a higher set of GWP (+ GTP + CGTP) numbers than the “green and natural, e.g. from melting permafrost” — or “non fossil” — CH4 molecule.

Ain’t “The (Climate) Science” wonderful ?

Gordon A. Dressler
Reply to  Mark BLR
June 4, 2022 12:14 pm

It is interesting—and at the same time not at all surprising—that the Table 7.15 “Emission metrics for selected species, global warming potential . . .” from IPCC AR6 omits mention of the species H20, which any scientist with an IQ above room temperature knows is the most significant greenhouse gas in the atmosphere . . . and by orders of magnitude more significant on an absolute GWP basis than is CO2.

Ed Reid
June 4, 2022 7:39 am

Several years ago, CFC propellants were replaced by HFA propellants in Measured Dose Inhalers used to deliver Albuterol to asthma patients for emergency relief. This is just SSDD.

June 4, 2022 7:51 am

Green world medicine.

Ed Reid
Reply to  Geo
June 4, 2022 8:38 am

Then, Soylent Green.

Old Man Winter
Reply to  Geo
June 4, 2022 9:14 am

Updated version!

June 4, 2022 8:20 am

Amsterdam, isn’t that where they have euthanasia!

Eddie Arnold had a hit song Make the World go Away. It starts with make the world go away and get it off my shoulders. Later on the song goes do you remember when you loved me before the world led me astray. He probably got the hots for a girl and got caught but it’s not his fault, it was the world that caused it.

The eco-phobic crowd is like that, they want the modern world to go away to save it, and it’s someone else’s fault. The object is to eliminate oil.

Ed Reid
Reply to  Olen
June 4, 2022 8:39 am

Most of that euthanasia is actually eldernasia.

Reply to  Ed Reid
June 5, 2022 2:03 am

if youre old frail and all you have to look forward to is a dubiously named aged “care” home or palliative care then a faster way out holds great appeal. no one needs to push it many of us want the option available on OUR decision, in our time of choosing

June 4, 2022 8:39 am

We’ll aside from the ridiculous weighting factors for these so called GHGs – like how do they run experiments to prove such claims (of course they don’t – it’s all based on computer models built upon ridiculous layers of lame assumptions), to have any actual modeled effects on climate we’d need emissions measured in the millions of tons per year. Wherein these gases are probably numbered in hundreds of tons per year – if that – and of course most of the gas is not released to the atmospher but is absorbed into the bloodstreams of patients where it undergoes various chemical reactions.

Warmunists have now jumped the shark that jumped another shark that jumped another shark that …

June 4, 2022 8:52 am

I suspect that the many-times-greater-than-CO2 warming potentials of these compounds are for an atmosphere clear of water vapor and CO2. Methane, for example, is stated in the article to be 86 times worse than CO2 but in the Earth’s atmosphere, the infrared bands in which it can operate are already near saturation from water vapor and CO2. There is little or nothing left in the affected wavelengths for methane to operate on. The consequence is that say doubling of methane in our atmosphere may increase temperature by an undetectable fraction of a degree. Search on Happer and Wijngaarden for a detailed report on the spectroscopic responses of atmospheric constituents.

Peta of Newark
June 4, 2022 8:53 am

Clutching at straws, trivia and minutiae

= desperation. Instinctively they know what garbage the theory of the green gas gases is and that everybody, even themselves, is/are bored to tears by it all
Hence the requirement/want/need for another ‘shock horror’ moment to keep this crappy old train on its tracks

Here’s another one..
Headline:”Hotter, Drier Nights Mean More Runaway Fires
They even quantify it in that one, it say s somewhere that there are 11, not 10, not 12, but eleven such ‘extra warm nights’ in Cali every year

That one should be easy to shoot down in flames……….
😀 😀

<Wonders if KY Jelly might fix ‘hot dry nights‘>
sorry, I’m sooooo sorry

John Kelly
June 4, 2022 8:57 am

Time to go back to biting hard on a leather strap. That’s medical progress for you.

Reply to  John Kelly
June 4, 2022 9:58 am

Saws can be used to make music also.

Reply to  John Kelly
June 4, 2022 3:21 pm

Or a bottle of rye and a chunk of leather

Or maybe a hit to the back of the head with a blunt object. If only it was just 0.5 deg cooler, life would be o so much better than painkillers.

June 4, 2022 9:09 am

Global heating is turning white Alps green, says Guardian
The impact of global heating on the Alps is visible from space, with the snow-white mountains increasingly colonised by green plants, according to a study of high-resolution satellite data.
Vegetated areas above the treeline in the Alps have increased by 77% since 1984, the study says. While retreating glaciers have symbolised the speed of global heating in the Alpine region, researchers described the increases in plant biomass as an “absolutely massive” change.
Good, ‘says’ I.
Global heating? Anyone knows what happened to global warming and climate change?
Ah, yes Anthropocene is over, Mundicalourcene adest !

June 4, 2022 9:12 am

Reducing emissions is pointless, useless, and foolish.

Richard Page
Reply to  pochas94
June 4, 2022 9:22 am

It’s worse than that (or than we thought?). It’s pointless societal self harm on a massive scale – the damage from this delusion will take decades to fix.

Right-Handed Shark
June 4, 2022 9:21 am

What’s the GWP of whatever they’re pumping into Soros to keep that walking corpse alive?

Richard Page
Reply to  Right-Handed Shark
June 4, 2022 11:10 am

The blood of virgin’s sacrificed on the altar of evil (must be read in the style of Vincent Price).

Trying to Play Nice
June 4, 2022 9:51 am

I vote we say goodbye to the climate alarmists and continue living a modern lifestyle. If they want to come after me I will have no qualms about defending myself.

David S
June 4, 2022 9:58 am

The solution to all these problems: Trump in 2024 …or sooner!

James F. Evans
June 4, 2022 10:05 am

If this is what it’s going to, they’ve lost contact with reality.

Linda Goodman
June 4, 2022 10:26 am

Is it time to stop pretending the breath of life is the gas of death?

Pat Frank
June 4, 2022 10:43 am

Email sent under the subject heading: environmental impact of inhaled anaesthetic agents

Dear Dr. Sperna Weiland,

Congratulations on the opportunity to speak on the subject at the upcoming Euroanaesthesia Congress, of which I learned here:

So, it seemed appropriate to let you know the impact of “Propagation of Error and the Reliability of Global Air Temperature Projections“ …

… on your thesis.

The entire case that greenhouse gas emissions warm the climate rests fully on climate models. But climate models have no predictive value. None.

This means the effect of anesthetics on the climate, if any, is undetectable and utterly invisible to modern science.

The climate itself shows nothing outside of natural variability.

It seems your thesis about anesthetics and climate has no basis at all. 

Just thought you’d like to know before committing yourself in public to an insupportable idea.



Reply to  Charles Rotter
June 4, 2022 5:13 pm

second least ….

Pat Frank
Reply to  Charles Rotter
June 5, 2022 11:55 am

But it’s a good poke in the eye, isn’t it.

And that’s what it was meant to be.

After considerable experience, I’ve given up trying to convince any of these people. Pokes in the eye are a fine second-best.

Rud Istvan
June 4, 2022 11:41 am

The crazier AGW alarmists get (and this here is CRAZY) the sooner the whole thing ends. Their fundamental problem is nothing they predicted has come true.

  1. The model predicted tropical troposphere hot spot does not exist.
  2. Arctic summer ice hasn’t disappeared.
  3. Sea level rise has not accelerated.

And none of their ‘solutions’ are the least bit practicable.

  1. For many major surgeries ONLY general anesthetic works.
  2. Renewables are intermittent requiring backup, so by definition are more expensive.
  3. There aren’t enough critical minerals for full EV, never mind the grid could never support them.

On the other hand in the end it doesn’t matter except for the interim economic waste, since there is NO AGW ‘crisis’. Most of the last now almost have century warming was likely natural variation, as the pause(s) taught.

June 4, 2022 12:00 pm

In the American Civil War, the Surgeon General for the Army said soldiers did not need the recently popularized chloroform for surgery by virtue of their training. In the early years of anaesthesia no individual surgeon or hospital considered it necessary for ALL patients. Those with higher education and women were given anaesthesia, while labourers were reckoned to not have the sensitivity that would render anaesthesia a benefit. (from old lecture notes based on various history of medicine books,)

I guess we could go back to this. The catch is that anaesthesia reduces the stress response and, thus, improves outcome from surgery. I would take a dim view of an anaesthetist who let his environmental concerns override medical issues. (“his” is deliberate here because almost all are male due to the fact that is is a specialty that requires on-site on-call.)

June 4, 2022 3:27 pm

No more laughing gas for you.

Too funny

June 5, 2022 12:39 am

Is it time to say goodbye to that most potent of greenhouse gases dihydrogen monoxide?

June 5, 2022 1:42 am

stupid woman!
fools like her will push price to soaring levels, for veterinary use especially birds. theyre fiddly enough to work on at the best of times
the local vet here insists on ONLY inhaled anaesthetics for surgeries which pushes prices sky high
they state that injectables arent as safe, the vet I use? uses injectables low dose (monitored by me usually, yes a vet who allows you to be there holding the animal while the ops are done) and a fast reversal. and at least 1/3 less cost

D.M. Anderson
June 5, 2022 3:32 pm

And no lead bullets to chomp on either!

June 6, 2022 1:39 am

“…But as we ourselves have demonstrated, you really can save a lot of energy by switching off most ORs during evenings, through the night and over weekends. In Amsterdam, we save around 360.000 kWh per annum by doing this”.
Because there are no emegencies in Amsterdam during the nights, evenings or weekends?

Phil Salmon
June 6, 2022 1:45 am

This is the latest directive from Davos. One by one, all the benefits to the general population of the technological advances of recent centuries, are being deliberately withdrawn. First affordable energy for living, heating and transportation. Now surgery with anaesthesia. It will remain fully available to the Davos elites of course.

Soon to follow are sewage systems and water supply – wait for an academic with an ugly name like “Sperma-Weiland” to discover that laying pipes for sewage and water is way too carbon-polluting. So that will have to stop too. Back to bucketing sewage into the streets and walking miles to a well for dirty water.

Phil Salmon
June 6, 2022 2:23 am

I’m surprised that they’re not already scavenging used anaesthetic gas with charcoal filters. That’s easy to do and preclinical systems all scavenge used isofluorane in that way.

June 6, 2022 6:53 am

You’re going to enjoy your next surgery.

June 6, 2022 2:52 pm

There are several factors governing what anaesthetic is used.
There is safety. There is a hierarchy with different types. For example, TIVA or Desflurane were introduced with fractional improvements in survival for example.
There are side effects. IV anaesthetics are not safe in some situations, and have a higher anaesthetic mortality (a poor outcome).
There is Time. Local/regional anaesthetics are relatively cheap. But they take time to set up, potentially halving the number of cases that can be done. Waiting times blow out. See below.
Then there is cost. Desflurane is expensive. TIVA/intravenous anaesthesia is expensive, particularly with the extra monitoring to make it safe. Moving to IV anaesthetics can potentially cripple the hospital budget. The result will be longer wait times.
So adopting the articles recommendations will result in an increase in complication, and a blow out in waiting times.

Anaesthetic gas quantities used are tiny. We used a fair bit of nitrous, but it degrades in the environment. Anaesthetic gases effect on the atmosphere are irrelevant.

An example of public waiting times is a neighbour. One to Two years waiting for a surgical consultation. Then one to two years wait time to get done. Every six months they ring to see if you are dead from your condition yet so they can take you off the lists. Welcome to free health care, Australian style.

As mentioned by others, the big issue is medical waste. A lot of equipment could be/used to be reused. A lot of waste could be recycled, at a profit, or donated to disadvantaged countries. (we used to steal a bit for use at home). Single use came in to cut costs, not for any other reason, in every hospital I worked in, but honestly, the cost savings were a con.
Instead, it all goes to landfill.

Dennis G. Sandberg
June 9, 2022 6:36 pm

About the time you think there will never be a more ridiculous example of otherwise intelligent people not being able to look at things quantitatively something like this comes along. Amazing.

Chris Thompson
June 14, 2022 6:02 am

I’ve been an anaesthesiologist for almost 40 years.

Over that time, we have seen a strong shift away from inhaled fluorinated volatile hydrocarbon anaesthesia to intravenous and regional anaesthesia. This has been better for patients. Low-flow gas delivery methods with better monitoring of gas/vapour composition have become normal, mostly for overall cost savings, but also because modern equipment makes those techniques much safer than in the past.

Fluorinated volatile hydrocarbon anaesthetics are a very blunt tool compared to propofol, modern synthetic opioids, and ultrasound-guided local anaesthetic blocks.

Walking around our post-operative recovery unit, most patients are comfortable and quickly alert. Nothing like the old days of volatile anaesthesia with nitrous oxide, where it was full of vomiting people groaning in discomfort.

The main reason that nitrous oxide has fallen out of favour is that it is associated with hypoxaemia, pressure changes in the middle ear, and post-operative nausea. Its usage was falling well before global warming was a consideration.

I still use a small amount of volatile anaesthetic vapour in almost every anaesthetic I perform, but the total amount of agent released into the atmosphere, per patient, having the same surgery, has probably fallen by about 10-20 times from the amount released when I was a young man.

Having said that, I’d resist moves to stop me using that small amount of volatile agent. Just a little bit reduces the likelihood of awareness should the IV delivery system fail, reduces the amount of intravenous agents required significantly, and reduces opiod ‘windup’ that can occur with high doses of intravenous opioids.

The majority of anesthesiologists will not change their practice significantly because of the environmental impact of waste volatile agents. In significant part that is because they are mindful that no judge would accept, in a case of awareness under anaesthesia, an explanation that no volatile agent was given to save the world from global warming.

So don’t be too concerned. You’ll probably get a better anaesthetic if it isn’t primarily delivered by volatile anaesthetic agent.

Having said that, wastage in medicine is unbelievable. Every central venous line we place comes with a scalpel, stainless steel scissors, stainless steel forceps, and a line trimmer tool, all of which are just thrown away, along with sundry plastic jars, trays, drapes, wipes, syringes, needles, polyurethane and PVC tubes, disposable plastic coated paper gowns, and so on. The amount of waste is staggering.

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