Canada’s health care system explains about five percent of the country’s greenhouse gas emissionsbut anesthesiologists at the Royal Columbian Hospital in Vancouver Subway are moving to curb the carbon footprint of their surgical unit.
Patients who go under the knife to RCH will no longer sleep with desflurane, a very potent pollutant that RCH anesthesiologists say has 25 times more greenhouse gas emissions than its alternative, sevoflurane.
The hospital will also return to the manufacturer the vaporizers used to administer the gas.
Eagle Ridge Hospital, a smaller acute care center in neighboring Port Moody, will also ban the anesthetic.
Dr. Cedric Ho, an anesthesiologist at Royal Columbian and Eagle Ridge Hospitals, acknowledges that both deflower and sevoflurate have the potential for global warming, but the differences between their climate impacts are obvious.
“If I had to give you the anesthetic (it will deflate) for two hours, it would be the same as if you and I got into an SUV and approached Kamloops (a 350-mile ride),” Ho said. “While the other option is like a short trip, only locally.”
Studies show treatment of patients with desflurane it has no significant benefit over other alternatives. He was referring to the individual preferences of anesthesiologists.
“It’s just like we could all have a different brand that we like for diet glue, but really, in a lot of ways, there’s not much difference.”
Royal Columbian Hospital follows a number of nationwide surgical units that have phased out desflurane, including Health Sciences North (HSN) in Sudbury, Ont.
Dr. Sanjiv Mathur, an HSN doctor, said the hospital had managed to eliminate 700 tonnes of carbon dioxide a year since it made the complete switch to sevoflurane.
“[It’s] the equivalent of riding a 28-mile-per-gallon car, driving four times to the moon and back, ”Mathur said.
Mathur is a co-author a report examining the climatic impacts of anesthetic gases and assign these preferences to marketing.
“It was marketed as the fastest for waking patients, so the reality was that it never occurred in more rigorous studies,” Mathur said.
Mathur said there were no differences in patient outcome and recovery after switching to sevoflurane.
Dr. Sanjiv Mathur is an anesthesiologist at Health Sciences North. (Casey Stranges / CBC)
It also indicates that more than 95% of anesthetic gases are not metabolized by the body.
“Everything we give the patient finally comes out again,” Ho said. “But in reality they’re only allowed to go up essentially like a chimney into the atmosphere outside the top of the hospital.”
He acknowledges that there are solutions to capture, dispose of and recycle the deflower, but insists that the best solution is not to use it at all.
Dr. Kai Chan, a UBC professor and research chair at the Institute for Resources, Environment and Sustainability, said moving away from desflurane operating rooms is a small but important step.
“Desflurane has been known to have a very high impact of greenhouse gases for more than a decade, and some hospitals have taken a long time to change,” Chan said.
Growing movement of health care providers seeking climate change “
Mathur said he is working with the Citizens Climate Lobby to ban desflurane, possibly by fixing carbon prices. He has researched how legislation can work to phase out the drug.
“I published a paper showing that if you apply the current Canadian carbon pricing mechanism to these agents (gas), desflurane would no longer be competitive and hospitals will probably not buy it.”
He says he wants Canada to be the first country to ban defloration and follow the UK NHS system’s national effort to reduce the country’s health footprint.
Mathur’s research on the climate impacts of anesthetic gases began when the Canadian Medical Association and other medical publications called on doctors to look for ways to minimize the carbon footprint of healthcare.
“Once I discovered that it was actually a threat to my children’s future, I started examining what we could really do,” Mathur said. “I was surprised to find that the gases that are used every day, defloration and sevoflurane, are, in fact, very high carbon footprint agents.”
According to Chan, RCH moving away from desflurane represents a “growing movement of health care providers seeking climate impacts. It calls for a framework that includes climate considerations in health operations.
“If all industries were responsible for the major greenhouse gases, that would be something that would have already been taken into account,” Chan said.
He says it would be difficult to ban a substance that is still considered effective and safe, but he hopes the ban on RCH desflurane will be extended to other hospitals.
“Our hope is that other groups will consider this decision and say, ‘Well, that was easy.’
With Belle Puri files