Innovative Operating Room Achieves 80% Reduction in CO2 Emissions

An operating room at Charité - Universitätsmedizin Berlin has successfully reduced its annual carbon dioxide (CO2) emissions from anesthesia gases by over 80% since 2018. This significant decrease was accomplished through the implementation of more environmentally friendly anesthetic agents, as detailed in a recent study published in the journal Anesthesia & Analgesia.

Volatile anesthetics have a detrimental impact on climate change, contributing to greenhouse gas emissions at a rate significantly higher than CO2. For instance, one kilogram of desflurane, a commonly used anesthetic, is estimated to have a warming effect nearly 8,000 times greater than the same quantity of CO2 over a five-year timeframe. The emissions produced during a seven-hour surgical procedure using desflurane are comparable to the emissions from driving a car for approximately 7,850 kilometers, a distance roughly equal to the journey from Berlin to Ulaanbaatar, Mongolia.

Recognizing the urgent need for a shift in practices, Charité initiated several educational programs in 2018 aimed at raising awareness about the climate impact of inhaled anesthetics among anesthesiologists. Dr. Susanne Koch, an anesthesiologist at Charité and lead investigator of the study, has emphasized the importance of education in facilitating this transition.

In late 2023, Charité made a pivotal decision to phase out desflurane across all departments. Instead, the focus has shifted to local anesthetics and intravenous options like propofol, which have a significantly lower environmental footprint. For situations requiring inhaled anesthetics, the use of sevoflurane is now preferred, particularly through a method known as 'minimal flow,' which further reduces gas emissions.

As a result of these changes, Charité has decreased its anesthesia-related carbon emissions from over 7,500 metric tons annually in 2018 to just 1,454 metric tons in 2023, which translates to a reduction of roughly 6,000 metric tons of CO2 each year. This reduction is equivalent to the annual emissions of about 300 households in Germany. Additionally, the transition has led to a nearly 50% decrease in annual costs for anesthetic agents since desflurane is one of the most expensive inhaled options.

Patients have not experienced any negative effects from this shift; in fact, propofol anesthesia has been associated with calmer awakenings and reduced nausea. While desflurane allows for precise control over anesthesia duration and depth, propofol, supported by EEG-based monitoring, has proven to be an effective alternative.

The study conducted by Dr. Koch and her team highlighted that the most effective measures for reducing CO2 emissions stemmed from management-level decisions that established standardized practices for anesthesiologists. Continuous educational efforts and engagement at both internal and external forums have also played a crucial role in achieving these sustainability goals.

This groundbreaking initiative by Charité demonstrates how healthcare institutions can lead the way in combating climate change while ensuring patient care remains uncompromised.