Hospitals can be hotspots for greenhouse gas emissions. But Boston Medical Center is part of a movement of hospitals changing their anesthesia to cut their footprint.
Megan Hall: Welcome to Possibly, where we take on huge problems like the future of our planet and break them down into small questions with unexpected answers. I’m Megan Hall.
If you’ve ever been put to sleep for surgery, you probably weren’t thinking about how that process affects the environment. But, it turns out, some forms of anesthesia create a lot of greenhouse gas emissions.
Hamid Torabzadeh and Meg Talikoff from our Possibly Team are here to explain.
Hamid Torabzadeh: Hi, Megan!
Meg Talikoff: Hello!
Megan Hall: Are you telling me I have to feel guilty about getting anesthesia during surgery? How does the stuff that makes me fall asleep have anything to do with climate change?
Hamid Torabzadeh: No one is asking you to feel guilty! Let’s just back up a bit to explain.
Meg Talikoff: General anesthesia, the medication that makes a patient unconscious during surgery, comes in a few different forms.
Hamid Torabzadeh: A lot of the time, it is a liquid that is vaporized and inhaled as a gas.
Meg Talikoff: What that means, is that it goes through the patient’s lungs, gets absorbed in the blood, and whatever is left over is exhaled by the patient back into the anesthesia machine.
Hamid: From that machine, the exhaled gas essentially gets dumped out into the atmosphere on the roof of the hospital.
Meg Talikoff: And that’s a problem because when those inhaled anesthetics get into the air, they help warm the planet, just like other greenhouse gasses.
Megan Hall: Interesting. Are all kinds of anesthesia the same?
Hamid Torabzadeh: Good question. Actually, no. One kind – desflurane – has what’s called a higher “global warming potential” than other anesthesia.
Meg Talikoff: That just means it’s a much stronger greenhouse gas than other anesthesia.
Megan Hall: Like how much more?
Meg Talikoff: Desflurane can warm the planet 2,500 times more than the same amount of carbon dioxide can.
Megan Hall: But it’s not like we’re powering our cars with this stuff. How many emissions could one surgery really create?
Hamid Torabzadeh: Let me put it this way, desflurane contributes the same greenhouse gas emissions during a five-hour surgery as taking a 2,000-mile car trip.
Meg Talikoff: And the US performs around 60,000 surgeries with anesthesia every day.
Hamid Torabzadeh: Anesthesia gasses aren’t anywhere close to the emissions from cars or heating houses, but chipping away wherever we can is the only way to get to zero emissions.
Megan Hall: Ok. So what do we do about this?
Meg Talikoff: Right here in New England, Boston Medical Center has almost completely stopped using desflurane.
Dr. Rafael Mauricio Gonzalez: Inhaled anesthetics, are all greenhouse gasses with global warming potential, so we targeted the one that was the highest, the worst of all the offenders.
Hamid Torabzadeh: That’s Dr. Rafael Mauricio Gonzalez, Boston Medical Center’s Vice Chair for Clinical Affairs and a practicing anesthesiologist.
Meg Talikoff: He says there are lots of other reasons why the hospital would switch away from desflurane, too:
Dr. Rafael Mauricio Gonzalez: In fact, it’s the weakest of the agents, so you have to use more volume. It’s the most expensive, it’s the most irritant to the patient. It’s pungent.
Hamid Torabzadeh: To wean itself off desflurane, Boston Medical Center restricted when it could be used, and made it less convenient to use.
Dr. Rafael Mauricio Gonzalez: If people had to use it, they had to go to the workroom, grab the vaporizer, which is heavy, bring it over, install it. It doesn’t take long, but it’s a pain in the butt.
Meg Talikoff: The technique worked. Anesthesia providers essentially stopped using it all-together.
Hamid Torabzadeh: Now, Boston Medical Center uses alternatives like sevoflurane.
Megan Hall: Is that anesthesia significantly better when it comes to greenhouse gas emissions?
Meg Talikoff: Yes. The same surgery with sevoflurane is equivalent to a 75-mile drive, which is way less than the 2,000 mile drive for desflurane.
Megan Hall: Wow! That’s actually a big improvement. Does it change anything for patients?
Meg Talikoff: Dr. Gonzalez says this switch has no impact on the quality or safety of care.
Dr. Rafael Mauricio Gonzalez: So between intravenous anesthesia and isoflurane and sevoflurane, for sure, everything is covered. No problem. You don’t need desflurane.
Hamid Torabzadeh: And Boston Medical Center isn’t the only place that’s ditching this anesthesia. Scotland banned desflurane in 2023 and the EU will follow in 2026.
Meg Talikoff: It’s nice to celebrate a win-win.
Hamid Torabzadeh: Moving away from this anesthetic seems to be better for patients and the planet.
Megan Hall: Great! Thanks, Hamid and Meg!
That’s it for today. You can find more information, or ask a question about the way your choices affect our planet, at askpossibly.org. You can also subscribe to Possibly wherever you get your podcasts or follow us on Instagram, Facebook, LinkedIn or X at “askpossibly”
Possibly is a co-production of Brown University’s Institute for Environment and Society, Brown’s Climate Solutions Initiative, and The Public’s Radio.
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