In March 2022, the system launched a Green Anesthesia Initiative to minimize the use of nitrous oxide and inhaled fluorinated ethers — which are environmentally harmful — while increasing the use of sevoflurane and intravenous anesthetics. Several other systems have implemented similar plans to phase out harmful anesthetic gases.
To evaluate whether the project resulted in patient harm, researchers compared 45,692 per-intervention patient records to 47,199 post-intervention patient records. They analyzed estimated carbon dioxide emissions, anesthetic dose, pain scores, postoperative nausea and vomiting, and reports of intraoperative awareness with explicit recall.
After rolling out the initiative, there was an average decrease of 14 kilograms per case of carbon dioxide equivalents. There were no clinically meaningful differences in anesthetic dose, pain scores or post-surgery nausea and vomiting, according to results published in The Lancet Planetary Health.
The study found a slight difference in intraoperative awareness events: One was reported in the pre-intervention group and two were reported in the post-intervention group.
“We’ve shown that small changes in our practice lead to big changes for the environment and, importantly, no changes for the patients,” Douglas Colquhoun, MD, first author and anesthesiology professor at Michigan Medicine, said in a news release.