在全身麻醉中平衡患者需求与环境影响的最佳实践:叙述审查和临床视角
Matthieu Jabaudon1, Bhadrish Vallabh2, H Peter Bacher3
1Department of Perioperative Medicine, CHU Clermont-Ferrand and iGReD, Université Clermont Auvergne, CNRS, INSERM, Clermont-Ferrand, France.
Anaesthesia, critical care & pain medicine
|May 6, 2024
概括
麻醉剂的生命周期评估 (LCA) 显示了来自sevoflurane制造/处置和propofol使用的温室气体排放. 需要更多的研究来比较吸入麻醉剂和全静脉麻醉 (TIVA) 的环境影响.
科学领域:
- 环境科学 环境科学
- 麻醉学 麻醉学
- 化学工程是化学工程的重要组成部分.
背景情况:
- 一般麻醉剂对环境的影响越来越受到审查,重点从吸入剂转向全静脉麻醉 (TIVA).
- 生命周期评估 (LCA) 是一种全面的方法,用于评估麻醉剂的环境足迹.
- 现有研究强调温室气体 (GHG) 排放是吸入麻醉剂和TIVA的主要关注点.
研究的目的:
- 提供与全身麻醉剂相关的环境风险概述,包括温室气体排放和非温室气体影响.
- 描述生命周期评估 (LCA) 方法及其对全身麻醉的应用.
- 审查和讨论可用的LCA研究,比较sevoflurane (吸入) 和propofol (TIVA).
主要方法:
- 综述现有关于一般麻醉剂对环境影响的文献.
- 生命周期评估 (LCA) 方法的描述.
- 对LCA研究进行分析,比较sevoflurane和propofol在其生命周期阶段 (制造,运输,使用,处置).
主要成果:
- 在sevoflurane制造/处置和propofol使用 (注射器/制造) 中确定了重要的温室气体排放热点.
- 目前的LCA研究主要集中在温室气体排放上,忽视了其他环境影响,如醇的水/土壤毒性.
- 在LCA数据中存在关于TIVA塑料组件制造,醇焚烧和吸入麻醉气体捕获技术的差距.
结论:
- 由于LCA的证据有限,因此无法得出关于sevoflurane和TIVA对环境影响的比较的最终结论.
- 需要进一步进行全面的LCA研究,以充分了解不同麻醉策略的环境足迹.
- 当前的麻醉实践应该优先考虑患者的需求和已建立的最佳实践,同时等待更强大的LCA数据.
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