• Bruce Campbell MD

Hospital Discharge

I am in the operating room working with an attending anesthesiologist I have known for years. “Tell me,” I ask, “Do you and your colleagues talk about the difference between Des and Sevo?”

He looks at me without responding.

“You see,” I continue, “there was a story on the radio about a hospital that has gotten rid of Desflurane because of the environmental impact. It is a much greater contributor to greenhouse gases than Sevoflurane.”

By way of explanation, after an anesthesiologist puts someone to sleep and hooks their endotracheal tube to the ventilator, the patient is given several drugs to reduce pain and stay asleep. They also breathe an “inhalational anesthetic” which causes amnesia and produces immobility. Two of the most common are Desflurane and Sevoflurane and, after the patient has breathed in and then exhaled whatever gas he or she has not absorbed, the remainder is sucked up and expelled as an exhaust outside of the hospital, where it mingles with the atmosphere.

“I tend to use Sevo because I assume it’s less expensive,” he says. “Is it really all that different?”

Fortunately, I have just searched for an article on my phone. “Here are the data.”

I show him. The use of desflurane for one hour provides the same carbon footprint as a car traveling 230 miles while one hour of sevoflurane is the equivalent of 30 miles. “It’s almost a factor of eight,” I say, stating the obvious. “Oh, and the cost is almost the same.”

“Well, I guess I was doing the right thing, even if I didn’t know it,” he says. “Sounds like something we need to hear about. Maybe younger people should take this up.”

I nod and we both return to our tasks. I help my resident, working step-by-step through a difficult procedure. He turns and supervises his trainee as she keeps our patient safely asleep.

“So, I get it,” my friend says. I pause what I am doing and look up, “What you’re saying is that if surgeons operated faster, there would be less global warming.”

“Hmm.” Good point, I think. I get back to work.