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7051221 
Journal Article 
The carbon footprint of anaesthesia How the choice of volatile anaesthetic affects the CO2 emissions of a department of anaesthesiology 
Richter, H; Weixler, S; Schuster, M; , 
2020 
Yes 
Anaesthesiologie und Intensivmedizin
ISSN: 0170-5334 
AKTIV DRUCK & VERLAG GMBH 
EBELSBACH 
154-161 
WOS:000531848400005 
Background: The health sector contributes considerably to national greenhouse gas emissions. In that regard, anaesthesiology and its use of volatile anaesthetics (VAs) takes on a particular significance. VAs are potent greenhouse gases, with desflurane exhibiting 2540 times the Global Warming Potential of CO2 whilst sevoflurane exceeds the effect of CO2 by only 130 times. In early 2018 the Department of Anaesthesia at the Kliniken Landkreis Karlsruhe placed limits on the use of desflurane. The primary objective of this study was to investigate the relevance of the intervention in relation to the department's overall carbon footprint.Methods: Departmental emissions were calculated for 2017 and 2018 in CO(2 )equivalents (CO(2)e) for three areas: (1) emissions generated by the use of VAs calculated on the basis of actual utilisation and respective Global Warming Potentials, (2) emissions deriving from single-use disposable devices, packaging and containers for fluids and drugs, categorised according to material and waste classes, and (3) emissions from fuel consumption on employees' everyday commute to work.Results: The emissions derived from single-use disposable devices, packaging and containers for fluids and drugs for 2017 and 2018 were 43.4 und 41.8 tCO(2)e respectively and totalled 48.5 und 48.6 t CO(2)e respectively from fuel consumption on employees' everyday commute to work. In 2017 the emissions from the use of VAs were 307.8 t CO(2)e or 77 % of the department's total emissions. Following a reduction in desflurane use, this number dropped to 36 t or 28% of total emissions in 2018. The department's overall emissions decreased by 68% from 399.7 t to 126.4 t CO(2)e.Conclusions: Germany's carbon footprint is 11 t per capita per annum and as such lies above the international average. Our calculations revealed very high work-related emissions for anaesthesiologists totalling 17.1 t CO(2)e per person and year. Decreased use of desflurane reduced these emissions to 5.4 t CO(2)e per person and year. Emissions per anaesthesiology case decreased from 38 to 12 kg CO(2)e. So long as efficient scavenging systems are not in place, the use of desflurane should therefore be questioned for ecological reasons. Further reductions in anaesthesia-related emissions should be addressed with utmost urgency.