Sustainable changes – reducing the use of anaesthetic gases

Sheffield Children’s is using alternatives forms of anaesthesia to help reduce the carbon footprint of the NHS. This change is part of work taking place across the Trust to make a range of environmental and sustainable changes, all part of the Trust green plan.

Currently there are numerous projects which help to improve sustainability across the Trust such as installing solar panels and Combined Heating Plant, the creation of the Green Group and a broad staff health and wellbeing programme. The green plan seeks to formalise these current projects and try to quantify their sustainable impact through the use of the Sustainable Development Units (SDU) Sustainable Development Assessment Tool (SDAT), in addition to developing new projects and ways of working across all areas of the Trust and with partners across the City.

Anaesthetic gases – what’s changed?

Anaesthetic gases form 5% of the carbon footprint of the NHS, including includes volatile anaesthetic agents (the sleepy ones), and nitrous oxide (the giggly one) which are all potent greenhouse gases.

After patients breathe them in and out during surgical procedures, these gases are released into the atmosphere, where they stay for up to 21 years. The gases also account for around 6% of the heating effect of greenhouse gases in the Earth’s atmosphere.

This is why anaesthetists at the Trust are using non-gas or ‘low flow’ gas anaesthesia, as well as ‘switching off’ when they can!

Zoe Green and Nina Plant, Consultant Anaesthetists at Sheffield Children’s, explained: “We have stopped using the most potent greenhouse anaesthetic gas – Desflurane. We can also choose to use total intravenous anaesthesia (TIVA) instead of anaesthetic gases. Although there are still significant environmental impacts from this method, the impact is thought to be lower than with anaesthetic gases.

“ ‘Low flow’ anaesthesia means that where we are using anaesthetic gases, we use closed anaesthetic circuits as much as possible.  These allow us to reduce our anaesthetic gas consumption and therefore reduce how much we release out into the atmosphere and save money too.

“ ‘Switching off’ refers to the scavenging system that removes the anaesthetic gases and releases them out into the atmosphere. It also uses lots of energy and can be switched off when not in use so we need to look at how we can do this possible.

“These alternatives, while better for the environment, are not perfect either so we need to keep looking at reducing, recycling and reusing where possible.”

To further reduce or avoid the need for anaesthesia, some patients having minor non-painful procedures can be sedated without general anaesthetic providing benefits to both themselves and the environment. Regional anaesthesia – such as numbing blocks – is also used widely in Theatres, helping to minimise the amount of general anaesthetic required.

What will happen in the future?

Anaesthetists at the Trust will continue to look at their whole practice with green glasses on to try and see where they can make changes – even if they’re small ones.

Zoe and Nina added: “We need to be mindful of the negative impact of volatile gases and nitrous oxide, and think more about how we use them.”

Sheffield Children’s Green Plan

You can find out more about the work we are doing to create a sustainable environment for our people and the children and young people we serve in the Sheffield Children’s Green Plan