Sentara hospitals reduce greenhouse gas emissions of anesthetic
Initiative with providers has significantly cut desflurane usage, lowering carbon footprint
The 12 Sentara Health hospitals in Virginia and North Carolina have reduced greenhouse gas emissions by limiting or eliminating the use of the inhaled anesthetic gas desflurane.
Compared to other inhaled anesthetics, desflurane has the most potent effect on the environment and lingers in the atmosphere for years longer.
Patients metabolize only 5% of inhaled anesthetics, with the remaining 95% exhaled, captured, and vented outdoors to prevent effects on surgery teams. Experts say desflurane has a disproportionate effect on the ozone layer.
Partnering with anesthesia providers, Sentara hospitals have reduced desflurane emissions from more than a million kilograms in 2019 to less than 100,000 kilograms in 2023.
“When desflurane came into use in the 1990s, we thought it was better for patients and easier on the environment than other gases,” said Holly McBryde Mason, M.D., an anesthesiologist at Sentara Martha Jefferson Hospital in Charlottesville, Va.
“We now know that desflurane’s effects on the environment are profound. There is a movement in our profession to use other inhaled gases with a lower carbon footprint, and other methods where it’s appropriate.”
Anesthesia providers have cut desflurane use by employing less-damaging gases, intravenous medications, and regional nerve blocks, as well as adopting best practices to reduce gas flow rates.
The Sentara electronic medical record includes alerts to anesthesia providers, allowing doctors and nurses to adjust the volume of anesthetics.
“The data we’re tracking shows that anesthesia providers across Sentara have been using environmentally sound practices to limit the use of inhaled anesthetic gases,” said Jon Horton, vice president of acute care pharmacy services for Sentara.
“They are continuing to look at opportunities to further reduce our carbon footprint from the operating room setting, and our clinical pharmacy team is collaborating in that effort,” Horton added.
Sentara hospitals have eliminated more than 200 specialized vaporizers that administer desflurane, though some remain because in certain circumstances there is no substitute.
“When we do our pre-surgery evaluations, there is a tiny cohort of patients who would benefit from desflurane to assure the best surgical outcomes,” added Dr. Mason.
“We may not be able to eliminate inhaled anesthetics, but we are doing our best to limit their effects on the environment.”
Sentara has convened a system task force on sustainability, chaired by Sentara Norfolk General Hospital President Liisa Ortegon, which supports the desflurane initiative.
“We are a big enough health system that when we commit to something, it makes a difference,” said Lisa Darger, director of sustainability for Sentara.
“Our goal is to reduce our collective carbon footprint and maximize healthy environments for our patients and employees, and to integrate sustainability into everything we do.”
Compared to other inhaled anesthetics, desflurane has the most potent effect on the environment and lingers in the atmosphere for years longer.
Patients metabolize only 5% of inhaled anesthetics, with the remaining 95% exhaled, captured, and vented outdoors to prevent effects on surgery teams. Experts say desflurane has a disproportionate effect on the ozone layer.
Partnering with anesthesia providers, Sentara hospitals have reduced desflurane emissions from more than a million kilograms in 2019 to less than 100,000 kilograms in 2023.
“When desflurane came into use in the 1990s, we thought it was better for patients and easier on the environment than other gases,” said Holly McBryde Mason, M.D., an anesthesiologist at Sentara Martha Jefferson Hospital in Charlottesville, Va.
“We now know that desflurane’s effects on the environment are profound. There is a movement in our profession to use other inhaled gases with a lower carbon footprint, and other methods where it’s appropriate.”
Anesthesia providers have cut desflurane use by employing less-damaging gases, intravenous medications, and regional nerve blocks, as well as adopting best practices to reduce gas flow rates.
The Sentara electronic medical record includes alerts to anesthesia providers, allowing doctors and nurses to adjust the volume of anesthetics.
“The data we’re tracking shows that anesthesia providers across Sentara have been using environmentally sound practices to limit the use of inhaled anesthetic gases,” said Jon Horton, vice president of acute care pharmacy services for Sentara.
“They are continuing to look at opportunities to further reduce our carbon footprint from the operating room setting, and our clinical pharmacy team is collaborating in that effort,” Horton added.
Sentara hospitals have eliminated more than 200 specialized vaporizers that administer desflurane, though some remain because in certain circumstances there is no substitute.
“When we do our pre-surgery evaluations, there is a tiny cohort of patients who would benefit from desflurane to assure the best surgical outcomes,” added Dr. Mason.
“We may not be able to eliminate inhaled anesthetics, but we are doing our best to limit their effects on the environment.”
Sentara has convened a system task force on sustainability, chaired by Sentara Norfolk General Hospital President Liisa Ortegon, which supports the desflurane initiative.
“We are a big enough health system that when we commit to something, it makes a difference,” said Lisa Darger, director of sustainability for Sentara.
“Our goal is to reduce our collective carbon footprint and maximize healthy environments for our patients and employees, and to integrate sustainability into everything we do.”
By: Dale Gauding