Carbon footprint in trauma surgery, is there a way to reduce it?

Elize W Lockhorst ^1,2, Philip M J Schormans ³, Cornelis A S Berende ³

⁰Department of Surgery, Amphia Hospital, Molengracht 21, 4818 CK, Breda, The Netherlands. elockhorst@amphia.nl.

Journal of Anesthesia, Analgesia and Critical Care +

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July 17, 2024

View abstract on PubMed

Summary

Switching trauma surgeries from general to regional anesthesia significantly cuts sevoflurane use, reducing environmental impact. Regional anesthesia also shows a trend towards lower complication rates compared to general anesthesia.

Area Of Science

Anesthesiology
Environmental Health
Trauma Surgery

Background

Inhaled anesthetics like sevoflurane contribute significantly to healthcare's carbon footprint.
Minimizing sevoflurane use is recommended, yet general anesthesia prevails in trauma surgeries.
Regional anesthesia offers an alternative for many trauma procedures.

Purpose Of The Study

To evaluate the environmental benefits of regional anesthesia versus general anesthesia in trauma surgery.
To compare complication rates between regional and general anesthesia for trauma patients.

Main Methods

Retrospective study of trauma patients (≥18 years) undergoing surgery for hand, wrist, hip, or ankle fractures (2017-2021).
Calculated hypothetical environmental gain assuming all surgeries used regional anesthesia.
Compared complication rates between regional and general anesthesia groups.

Main Results

General anesthesia was used in 95% of 2,714 trauma surgeries; regional anesthesia in 5%.
A switch to regional anesthesia could reduce sevoflurane use by 92kg, equivalent to 406,553 km of car travel.
Complication rates were higher with general anesthesia (7.7%) than regional anesthesia (6.9%), though not statistically significant (p=0.75).

Conclusions

Significant environmental benefits are achievable by reducing sevoflurane use in trauma surgeries suitable for regional anesthesia.
Regional anesthesia presents a viable, potentially safer alternative for specific trauma surgeries.

Keywords:

Anaesthesia Carbon footprint Traumasurgery