Monash Health Department of Anaesthesia puts the green in greenhouse gases

An anesthesiologist stands in a room holding a canister of the anesthetic agent desflurane. He wears blue scrubs, glasses and a white N95 mask.

The Monash Health Department of Anaesthesia is helping kick greenhouse gases to the curb by banning an environmentally unfriendly anaesthetic agent.  

The volatile anaesthetic, called desflurane, is an incredibly potent greenhouse gas and has more than two and a half thousand times the global warming potential of carbon dioxide. 

Staff anaesthetist Dr Barbara Rodriguez said banning the agent was an easy decision. 

“It’s not been shown to have any significant clinical advantage to other anaesthetic agents,” she said. 

“Even using a little bit of it significantly contributes to our overall emissions.” 

Anaesthetists will continue to use sevoflurane for procedures where a volatile anaesthetic – a gas used to keep people asleep – is needed. Other alternatives include TIVA (total intravenous anaesthesia) and regional anaesthesia. 

“This has significantly less carbon dioxide emissions – in comparison, desflurane is about 50 to 60 times worse than sevoflurane,” Dr Rodriguez said.

Even a small amount of the anesthetic agent desflurane can have a significant impact on greenhouse gas emissions.

While Monash Health has been steadily reducing the amount of desflurane used over the last few years, Dr Rodriguez said it was still important to completely stop using it due to the disproportionate emissions impact. 

“In 2021, Desflurane use by volume was 1.7 per cent of our total volatile use, but since it has one third the potency of Sevoflurane, it’s closer to 0.6 per cent in terms of anaesthetic equivalence,” she said. 

“Yet this still accounted for 25 per cent of CO2 equivalent emissions from volatile anaesthetics – so it’s much worse with no significant patient outcome benefits.” 

So far, the response has been overwhelmingly positive. 

“People are becoming more aware of the importance of climate change,” Dr Rodriguez said. 

“Climate change is having an effect on people’s health, and we don’t want our activities to be undermining the healthcare we are providing by exacerbating this problem.” 

The staff anaesthetist said many clinicians would like to see a continued effort and change in environmentally sustainable practices within the health service to continue combatting global warming. 

“I hope this can be the first of many actions,” she said. 

The change came into effect on April 1 and the remaining desflurane inventory will be sent back to the provider.