Environmental and Monetary Impact of Low Flow Anesthesia
Ada Nil TOPRAK, Duygu Demiröz ASLAN, Yusuf Ziya ÇOLAK
Türk Eğitim Vakfı İnanç Türkeş Özel Lisesi (TEVİTÖL)
Giriş:
Since the importance of environmental health is exponentially increasing and the intensive usage of anesthetic agents act against it by increasing greenhouse gas emissions, the need for an increase in prevalence of Low Flow Anesthesia (LFA) is distinct. Accompanied by the environmental impacts, LFA has also positive effects on patient health. The primary focus of our study is to demonstrate the level of reduction to be achieved in the amount of gas released into the atmosphere with different FGF.
Gereç ve Yöntem: After ethical approval, 72 donor hepatectomy patients were included in prospective, observational, and cross-sectional study, divided in 4 groups of 18. In group P5 and F5, 5mL/kg FGF was used by primus (Drager®) and Flow-i (Getinge®) respectively. In group F10 and F20, FGF were used 10 and 20 respectively. The demographic, respiratory, hemodynamic, and consumption data were collected.
Bulgular: There were no significant differences between groups about demographic hemodynamic and respiratory parameters. The FGF provided sustained FiO2:0.4 in all groups. The anesthetic agent consumption in Group P5 and F5 was similar (11.1mL/h, 10.1mL/h, respectively) whereas, compared to Groups F10 and F20 (13.2mL/h and 22.2mL/h, respectively) it was distinctively lower by 30% and 54% respectively (p<0.001).
Tartışma ve Sonuç: Considering the impacts that were mentioned before; the FGF of 5mL/kg performed, the cost of anesthesia was reduced at least 30%. Each year almost 234 million surgeries are performed. If 100 million surgeries were to be suitable to use LFA and the mean duration time were to be 3 hours per surgery, the total utilization of LFA would be 300 million hours. Hence, if 5 mL/min FGF were to be used, 54% (3,6 billion mL) less anesthetic agent being released to the atmosphere. Additionally, considering the carbon emission which is 24kg-CO2 per hour of surgery, the environmental and monetary impact is non-negligibly abundant.
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