A true story: United States of America, early morning, Providence Hospital in Portland, Oregon. A middle-aged lady is lying on an operating table, surgeons are about to remove a stomach tumor. Doctor Brian Chesebro puts the anesthesia mask on her and says, “Now you're going to breathe into this mask, and I'm going to put sevoflurane into your airway.”
Sevoflurane is one of the most used gases in anesthesia: the other is desflurane.
Consider that only 5% of the gas delivered in operating room comes metabolized by the patient, the rest is sucked up by the ventilation system to prevent it from producing effects on the operating team.
And then? Then it ends up in the atmosphere, along with the other greenhouse gases.
Sevoflurane and desflurane are very similar: the former requires more patient monitoring, but is not difficult to manage, in the end one is as good as the other. What he anesthetists maybe don't know is that desfluorane is much, much more harmful to the environment.
Doctor Chesebro, on the other hand, is interested in the matter: he is a doctor who is very attentive to the environment and concerned about the future of the planet. That's why he spent many hours researching anesthetic gases, and he has realized that desflurane can retain heat in the atmosphere 20 times more than sevoflurane and remains in the atmosphere for 14 years, while sevoflurane its cycle ends in just one year.
At that point he opened a large black notepad and wrote down all the gases used by his colleagues, with graphs on their use and relative environmental impact, and he show yourself to your group doctor: “all I did was show him some data. I didn't want to be pushy, just inform them."
One of the doctors he has found it interesting the analysis, Dr. Michael Hartmeyer says “I wish I had known before, my operating practice would have changed a long time ago”.
Among the data that struck Hartmeyer is the one on production of greenhouse gases: Desflurane is equivalent to driving a fleet of 12 large SUVs throughout the operation. Using sevoflurane is equivalent to driving a medium-sized car: it is not quite the consumption of your Toyota Prius, a hybrid car, but at least it's not a means environmental disaster.
“I try to take precautions. I don't turn on too many lights, take shorter showers, or anything. I do what I can. But in my profession, changing the anesthetic gas is a very simple gesture that can have a gigantic impact."
Other colleagues in the hospital also based their choices on sevuflorane, and were even more pleased to know that it is also much cheaper. Each of them has product for the structure a saving of 13.000 dollars per year: together they exceed half a million dollars of annual savings.
Providence Hospital Director Lisa Vance in announcing the transition official of sevufloran as an anesthetic gas said that the change was not made for money reasons: it was made because the WHO said that climate change is the 1st global health problem of the 21st century.
Chesebro's efforts, which are slowly coming together expanding to other hospitals, are as important as the fact that America's healthcare sector is responsible for 10% of all greenhouse gas emissions in the country.
The counterarguments of pharmaceutical companies
One of the major producers of both gases, the Baxter International, says that providing a range of choices to patients is important: "after all," reads one of his recent press releases, "anesthetic gases have a equivalent impact to just 0,01% of fossil fuels.”
Even if it were small or large, why not reduce your impact on the environment anyway?
Data is the least contestable thing in the world. The data speaks. Use the sevoflurane allowed to Dr. Chesebro to release the gases into the atmosphere greenhouse equivalent to a trip of 65 kilometers. If he had used desflurane, it would have been like driving more than 1900 kilometers.
