When we talk about the beauty industry and what beautifies us, what comes to mind are usually the following – skincare, cosmetics, or hair care. But what about cosmetics surgery? They beautify us as well, don’t they. While they do, their environmental impact may be another area that is often overlooked as well. Specifically, this blog looks at the use of anesthesia during cosmetic surgery. While the use of anesthesia has been viewed as indispensable, beyond the traditional risks inherent to any drug in use, inhaled anesthesia being exceptionally strong greenhouse gases (GHG) with a global warming potential of over 2000 times of carbon dioxide, poses concern as well (Gadani & Vyas, 2011).
Anesthesia is available in liquid and gaseous forms, but inhaled anesthesia is preferred due to the gaseous properties which allow the rapid introduction of an agent into arterial blood via pulmonary circulation. As such, in a surgical setting where anesthesia is provided to the patient, it is inhaled. However, only about 5% is metabolised while the majority is exhaled into a ventilation system (Foden-Vencil, 2019). Without a proper system, these gases are released into the atmosphere. Besides the preferred choice of gaseous anesthesia, the use of Desflurane over other options is preferred as well. The low solubility of Desflurane shortens the recovery time of patients thus displaying a more favourable recovery profile compared to other alternatives. As such, desflurane would appear to be the preferred alternative to other options such as isoflurane, sevoflurane and propofol. Yet, Desflurane is in fact much worse for the environment.
Not only is Desflurane 20 times as powerful in its global warming potential as sevoflurane, but its average lifetime in the atmosphere is also as long as 14 years while sevoflurane breaks down within a year (Broadcasting, 2019). An Australian study confirmed the disproportionate GHG emissions of desflurane, compared to sevoflurane. While desflurane represented a small proportion (21%) of inhaled anaesthesia use, it accounted for the majority (81%) of the total annual GHG emissions instead (Varughese & Ahmed, 2021). With the global warming impact of inhaled anesthesia increasing from 0.03% in 1999 to 0.6% recently, the cumulative levels of these GHG mandate us not to be short-sighted of its effects (Gaya da Costa et al., 2021). As such, while inhaled anesthesia is estimated to represent a small contribution to total GHG emissions, its long-term cumulative impact on climate change remains important.
With medical purposes being of utmost priority, the environmental impacts of these institutions are downplayed. At present, anaesthesiologists remain oblivious to the climate impacts. However, sustainable anesthesia practice can easily be achieved with a conscious decision-making process for the choice of and use of inhaled anesthesia.
References
Broadcasting, K. F.-V., Oregon Public. (2019, May 8). Effects of surgery on a warming planet: Can anesthesia go green? Kaiser Health News. https://khn.org/news/effects-of-surgery-on-a-warming-planet-can-anesthesia-go-green/
Foden-Vencil, K. (2019, May 6). Effects of surgery on a warming planet: Can anesthesia go green? NPR. https://www.npr.org/sections/health-shots/2019/05/06/716415598/effects-of-surgery-on-a-warming-planet-can-anesthesia-go-green
Gadani, H., & Vyas, A. (2011). Anesthetic gases and global warming: Potentials, prevention and future of anesthesia. Anesthesia: Essays and Researches, 5(1), 5. https://doi.org/10.4103/0259-1162.84171
Gaya da Costa, M., Kalmar, A. F., & Struys, M. M. R. F. (2021). Inhaled anesthetics: Environmental role, occupational risk, and clinical use. Journal of Clinical Medicine, 10(6), 1306. https://doi.org/10.3390/jcm10061306
Varughese, S., & Ahmed, R. (2021). Environmental and occupational considerations of anesthesia: A narrative review and update. Anesthesia & Analgesia, 133(4), 826–835. https://doi.org/10.1213/ANE.0000000000005504