Carbon Footprint in Trauma Surgery, is There a Way to Reduce It?

Overview

Journal J Anesth Analg Crit Care

Date 2024 Jul 17

PMID 39020415

Authors

Elize W Lockhorst

Philip M J Schormans

Cornelis A S Berende

Pieter Boele van Hensbroek

Dagmar I Vos

Affiliations

Soon will be listed here.

Abstract

Background: Inhaled anaesthetic agents like sevoflurane contribute for approximately 5% to healthcare's carbon footprint. Previous studies suggested that the use of these agents should be minimized. Although multiple trauma surgeries can be performed under regional anaesthesia, most are performed under general anaesthesia. This study aims to evaluate the environmental benefits of using regional anaesthesia over general anaesthesia and to compare the associated complication rates.

Methods: This retrospective study included all trauma patients (≥ 18 years) who underwent surgical intervention for hand, wrist, hip, or ankle fractures from 2017 to 2021. The hypothetical environmental gain was calculated based on the assumption that all surgeries were performed under regional anaesthesia. Complication rates were compared between regional and general anaesthesia.

Results: Of the 2,714 surgeries, 15% were hand, 26% wrist, 36% hip, and 23% ankle fractures. General anaesthesia was used in 95%, regional in 5%. Switching this 95% to regional anaesthesia would reduce the sevoflurane use by 92 k, comparable to driving 406,553 km by car. The complication rate was higher with general anaesthesia compared to regional (7.7% vs 6.9%, p = 0.75).

Conclusion: The potential gain of the reduction of sevoflurane in trauma surgeries which can be performed under regional anaesthesia can be significant.

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