Desflurane is a common anesthetic used in hospital operating rooms worldwide. It’s also a climate super pollutant. Now, several decades after the drug was first introduced, a growing number of US hospitals have stopped using the anesthetic because of its outsized environmental impact. On January 1, the European Union went a step further, prohibiting its use in all but medically necessary cases.
Desflurane is more than 7,000 times more effective at warming the planet over a 20-year period than carbon dioxide on a pound-for-pound basis. However, curbing its use alone won’t solve climate change. The anesthetic contributes only a small fraction of total global warming, which is driven by far larger volumes of carbon dioxide and methane emissions.
Still, emissions from the drug add up. Approximately 1,000 tons of the gas are vented from hospitals and other health care facilities worldwide each year. The emissions have a near-term climate impact equivalent to the annual greenhouse gas emissions from approximately 1.6 million automobiles.
For Jodi Sherman, an anesthesiologist at Yale University and medical director of sustainability for the Yale New Haven Health System, the decision to discontinue use of desflurane is clear.
“It has a relatively significant impact in health care delivery in a hospital on the ground and it’s something where we have easy fixes,” said Sherman.
Health care accounts for 8.5 percent of US greenhouse gas emissions, a figure twice the global average for the sector. At the hospital level, approximately 5 percent of climate pollution comes from anesthesia gases. At the same time, less than 5 percent of inhaled anesthetics are metabolized in patients. The vast majority of the gas is simply vented into the atmosphere.
Medical professionals are increasingly viewing health care, and anesthesia in particular, as an opportunity to lead in reducing emissions.
“We have a huge role to play in not just contributing to greenhouse gas emissions but also to be leaders in decreasing US greenhouse gas emissions,” said Shaneeta Johnson, professor of surgery and global health at the School of Global Health at Meharry Medical College in Nashville. “Small changes make a big difference.”