Sentara Health officials say they are reducing climate pollution from a greenhouse gas used for anesthesia, part of the system’s wider effort to reduce health care’s sizable carbon footprint.
The health system’s hospitals throughout Virginia and North Carolina have largely phased out the anesthetic gas called desflurane, said Dr. Holly Mason, an anesthesiologist at Sentara’s Martha Jefferson Hospital in Charlottesville.
Sentara says it cut emissions over the past five years from more than a million kilograms to less than 100,000.
Mason said desflurane came out in the early 1990s and was popular because of its stability at a molecular level. Patients could quickly go under and wake back up.
Also, “we thought at the time it was a better environmentally friendly gas,” she said. “Turns out that’s not the case.”
The molecular stability that made it favorable is also what drives its large carbon footprint.
When patients inhale desflurane before surgery, only about 5% stays in the body. The rest is vented outdoors and can linger in the atmosphere for years, warming the planet.
Desflurane is the most potent greenhouse gas among inhaled anesthetics, according to the American Society of Anesthesiologists. It can trap heat in the atmosphere at a rate more than 2,000 times greater than carbon dioxide. (Carbon dioxide is still by far the biggest contributor to climate change due to the massive quantity emitted.)
Last year, Scotland became the first country to ban desflurane use at publicly-funded hospitals.
The health care industry accounts for about 8.5% of all greenhouse gas emissions in the U.S., including from powering energy-intensive facilities and washing large amounts of sheets and towels to keep everything sterile.
Sentara recently hired its first-ever sustainability director in an effort to start reducing climate impacts.
Mason said desflurane “really is a piece of a larger puzzle.”
To cut down reliance on the gas, doctors have turned to other techniques like intravenous anesthetics versus those that are inhaled. They also try to do more regional anesthesia – numbing a specific area of the body – rather than general, Mason said.
Health providers still have to use desflurane in a small number of circumstances, such as when a patient needs to wake up quickly after a procedure.
Mason said Sentara’s electronic medical record now includes alerts to anesthesia providers, reminding them to minimize desflurane use by doing things like cutting back the dosage once a patient is already asleep.
