Amsterdam UMC location University of Amsterdam, Anaesthesiology.
Amsterdam UMC Centre for Sustainable Healthcare, Amsterdam, The Netherlands.
Curr Opin Anaesthesiol. 2023 Apr 1;36(2):188-195. doi: 10.1097/ACO.0000000000001243. Epub 2023 Jan 23.
The excessive growth of the health sector has created an industry that, while promoting health, is now itself responsible for a significant part of global environmental pollution. The health crisis caused by climate change urges us to transform healthcare into a sustainable industry. This review aims to raise awareness about this issue and to provide practical and evidence-based recommendations for anaesthesiologists.
We offer seven recommendations for anaesthesiologists that want to transform their own practice. 1. Use total intravenous anaesthesia over inhalation-based anaesthesia. 2. Use ultra-low fresh gas flow (<0.5 l min) during inhalation based anaesthesia and higher flows (4–6 l min) during total intravenous anaesthesia. 3. Anaesthetic gas capturing technology may have limited environmental benefit, while it increases cost. 4. In the clinical setting, epidural or intravenous analgesia during labour is preferred over nitrous oxide inhalation. 5. Properly designed air treatment systems save energy and reduce cost. 6. Unoccupied set-back of air treatment systems can save up to 70% of energy. 7. Reusable equipment is almost always associated with a lower environmental impact and lower costs compared with single-use disposables.
This review offers evidence-based recommendations, along with their financial impact, to improve the sustainability of anaesthesiology practice in the operating room.
卫生部门的过度增长已经形成了一个产业,在促进健康的同时,现在自身也成为了造成全球环境污染的主要原因之一。气候变化带来的健康危机促使我们将医疗保健转变为可持续发展的产业。这篇综述旨在提高人们对此问题的认识,并为麻醉师提供实用的、基于证据的建议。
我们为希望改变自身实践的麻醉师提供了 7 条建议。1. 使用全静脉麻醉而非吸入性麻醉。2. 吸入性麻醉时使用超低新鲜气流(<0.5 l/min),全静脉麻醉时使用更高气流(4-6 l/min)。3. 麻醉气体捕获技术可能对环境有益有限,同时会增加成本。4. 在临床环境中,分娩时硬膜外或静脉镇痛优于吸入一氧化二氮。5. 适当设计的空气处理系统可节省能源并降低成本。6. 不使用的空气处理系统待机可节省高达 70%的能源。7. 与一次性使用的一次性用品相比,可重复使用的设备几乎总是与更低的环境影响和更低的成本相关。
本篇综述提供了基于证据的建议及其对财务的影响,以改善手术室麻醉实践的可持续性。