Australian State Removes Common Anaesthetic in ‘Low Carbon’ Push

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A common anaesthetic agent that has been identified as a potent greenhouse gas has been approved for immediate removal from hospitals in Western Australia, as part of its health department’s mission to cut carbon footprint.

Desflurane, one of the most commonly used anaesthetic drugs in surgeries, has 2,540 times the global warming potential (GWP) of carbon dioxide, according to Western Australia’s public health system (WA Health).

Calculated by the United Nation’s Intergovernmental Panel on Climate Change, GWP describes the amount of heat trapped over a 100-year period within the atmosphere, compared with a similar mass of carbon dioxide (CO2).

For reference, CO2 has a GWP of 1.

Desflurane will be phased out from all public hospitals, but can still be made available through an individual patient approval process if no alternative can be used.

This Australian-first decision was driven by clinicians and reflects a broader strategy to create a climate-resilient and sustainable healthcare system, Chief Health Officer Dr. Andrew Robertson said, as WA Health strives to align with government targets of reducing greenhouse gas emissions by 80 percent below 2020 levels by 2030 and achieving net-zero emissions by 2050.

“When you consider the logistics involved in delivering care to people around our vast State, it is not surprising a considerable level of emissions are attributable to the health sector,” Dr. Robertson said in a statement on Oct. 5.

“Clinical care, including pharmaceuticals, is responsible for a significant portion of the carbon emissions of the health sector.

“We need to do everything we can to reduce this footprint, and with clinicians, we’re looking at ground-breaking and practical ways to make our health system as low carbon as possible, while delivering high-quality care to patients.”

Over 50 Times Higher Emissions Than Alternatives

The advantages of desflurane over other common anaesthesia such as sevoflurane and isoflurane are its low blood solubility and rapid induction. It has the most rapid onset of the inhaled anaesthetics.

However, according to WA Health, desflurane emits 50 to 60 times more carbon emissions than sevoflurane.

One hour of desflurane anaesthesia is equivalent to driving 320 kilometres (199 miles) in a petrol or diesel car, according to WA Health.

The health department endorsed the decision after consultation with various stakeholders, including anaesthetics, therapeutic advisors, and drug experts.

The move was the result of an innovative effort among staff to bring about system-level changes, according to Dr. Adam Crossley, who is the medical lead for Climate Health and Environmental Sustainability at Fiona Stanley Fremantle Hospitals.

Dr. Adam Crossley Courtesy of WA Health

“While the team are proud leaders in climate health, this truly was a collaborative effort, taking inspiration from various groups and initiatives,” Dr. Crossley said.

“We are committed to being more environmentally friendly while also maintaining the highest level of patient care.”

He said desflurane’s removal highlighted the healthcare sector’s dedication to a “low carbon” approach to surgery and patient care.

“Through this project, we brought together our clinical expertise and sustainability champions, with the common goal of reducing our carbon footprint. Seeing this initiative rolled out statewide really demonstrates we’re on the right track to a more sustainable future in healthcare,” he added.