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Balancing patient needs with environmental impacts for best practices in general anesthesia: Narrative review and clinical perspective.
Jabaudon, Matthieu; Vallabh, Bhadrish; Bacher, H Peter; Badenes, Rafael; Kehl, Franz.
Afiliación
  • Jabaudon M; Department of Perioperative Medicine, CHU Clermont-Ferrand and iGReD, Université Clermont Auvergne, CNRS, INSERM, Clermont-Ferrand, France. Electronic address: mjabaudon@chu.clermontferrand.fr.
  • Vallabh B; Global Medical Affairs, AbbVie Biopharmaceuticals GmbH, Dubai, United Arab Emirates.
  • Bacher HP; Global Medical Affairs, AbbVie Inc., North Chicago, IL, USA.
  • Badenes R; Department of Anesthesiology and Surgical-Trauma Intensive Care and Pain Clinic, Hospital Clínico Universitario de Valencia, University of Valencia, Valencia, Spain.
  • Kehl F; Department of Anesthesia and Intensive Care Medicine, Klinikum Karlsruhe, Karlsruhe, Germany.
Anaesth Crit Care Pain Med ; 43(4): 101389, 2024 Aug.
Article en En | MEDLINE | ID: mdl-38710324
ABSTRACT
Discussions of the environmental impacts of general anesthetics have focused on greenhouse gas (GHG) emissions from inhaled agents, with those of total intravenous anesthesia (TIVA) recently coming to the forefront. Clinical experts are calling for the expansion of research toward life cycle assessment (LCA) to comprehensively study the impact of general anesthetics. We provide an overview of proposed environmental risks, including direct GHG emissions from inhaled anesthetics and non-GHG impacts and indirect GHG emissions from propofol. A practical description of LCA methodology is also provided, as well as how it applies to the study of general anesthesia. We describe available LCA studies comparing the environmental impacts of a lower carbon footprint inhaled anesthetic, sevoflurane, to TIVA/propofol and discuss their life cycle

steps:

manufacturing, transport, clinical use, and disposal. Significant hotspots of GHG emission were identified as the manufacturing and disposal of sevoflurane and use (attributed to the manufacture of the required syringes and syringe pumps) for propofol. However, the focus of these studies was solely on GHG emissions, excluding other environmental impacts of wasted propofol, such as water/soil toxicity. Other LCA gaps included a lack of comprehensive GHG emission estimates related to the manufacturing of TIVA plastic components, high-temperature incineration of propofol, and gas capture technologies for inhaled anesthetics. Considering that scarce LCA evidence does not allow for a definite conclusion to be drawn regarding the overall environmental impacts of sevoflurane and TIVA, we conclude that current anesthetic practice involving these agents should focus on patient needs and established best practices as more LCA research is accumulated.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Anestésicos por Inhalación / Ambiente / Gases de Efecto Invernadero / Anestesia General Límite: Humans Idioma: En Revista: Anaesth Crit Care Pain Med Año: 2024 Tipo del documento: Article Pais de publicación: Francia
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Anestésicos por Inhalación / Ambiente / Gases de Efecto Invernadero / Anestesia General Límite: Humans Idioma: En Revista: Anaesth Crit Care Pain Med Año: 2024 Tipo del documento: Article Pais de publicación: Francia