The long-term influence of green nudges on the consumption of desflurane and on the carbon footprint of general anaesthesia: A retrospective study

IF 0.7 Q3 ANESTHESIOLOGY

Trends in Anaesthesia and Critical Care Pub Date : 2025-10-01 DOI:10.1016/j.tacc.2025.101592

Leonard Santen , Florian Windler , Mark Coburn , Birgit Bette , Se-Chan Kim , Christian Bode , Philippe Kruse

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Abstract

Introduction

The medical sector is responsible for a significant share of greenhouse gas emissions. It is imperative that a transition towards ecological sustainability takes place. Nevertheless, initiatives for healthcare providers to reduce emissions remain limited in clinical practice, and climate-damaging behaviour persists. A salient example is the regular use of desflurane in anaesthesia. In order to promote sustainable clinical practice, the implementation of behavioural decision support mechanisms, so called nudges, could be a promising approach.

Methods

A retrospective study was conducted to analyse the effectiveness of nudges to reduce the consumption of desflurane. The nudges comprised structural modifications to the workplace, with desflurane vaporisers being replaced with those for sevoflurane and isoflurane. The effectiveness of the nudges was evaluated by analysis of the desflurane's order volume. In addition, the emissions of greenhouse gases were normalised to the number of surgical procedures performed. Finally, the economic benefit of reduced desflurane consumption was investigated based on the purchase price.

Results

Following the implementation, desflurane was no longer utilised in the long term. Overall, these nudges resulted in a 91 % reduction in emissions of volatile anaesthetics per quarter, equivalent to 219 t CO₂e. Consequently, the average greenhouse gas emissions per surgical procedure were reduced by 42.2 kg CO₂e. Furthermore, the costs for volatile anaesthetics decreased by 63.9 %, amounting to a reduction of €18,237.28.

Discussion

The implementation of nudges has been demonstrated to lead to a cessation of desflurane consumption, thereby supporting the green transformation of the healthcare sector. In the future, green nudges favouring sustainable clinical practice are poised to assume greater significance as a cost-effective and readily implementable sustainability measure.

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绿色轻推对地氟醚消费和全身麻醉碳足迹的长期影响：一项回顾性研究

医疗部门对温室气体排放的很大一部分负有责任。向生态可持续性的过渡势在必行。然而，在临床实践中，医疗保健提供者减少排放的举措仍然有限，破坏气候的行为仍然存在。一个突出的例子是在麻醉中经常使用地氟醚。为了促进可持续的临床实践，实施行为决策支持机制，即所谓的“轻推”，可能是一种很有前途的方法。方法回顾性分析轻推减少地氟醚用量的效果。这些改进包括对工作场所的结构修改，将地氟烷蒸发器替换为七氟烷和异氟烷蒸发器。通过对地氟醚订单量的分析来评价微推的有效性。此外，温室气体的排放量与外科手术次数归一化。最后，根据收购价格，对降低地氟醚用量的经济效益进行了研究。结果实施后，地氟醚不再长期使用。总体而言，这些措施导致每季度挥发性麻醉剂的排放量减少91%，相当于219吨二氧化碳当量。因此，每次手术的平均温室气体排放量减少了42.2公斤二氧化碳当量。此外，挥发性麻醉剂的费用下降了63.9%，减少了18,237.28欧元。已经证明，实施轻推可以停止地氟醚的消费，从而支持医疗保健部门的绿色转型。在未来，绿色推动有利于可持续临床实践准备承担更大的意义，作为一个具有成本效益和易于实施的可持续发展措施。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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