10/06/2024 | Press releases

Harmful greenhouse gas removed from hospital theatres

A harmful greenhouse gas used in ‘traditional’ anaesthetics is no longer in use at Colchester and Ipswich hospitals.

Nitrous oxide has been used for many years as an anaesthetic. But the gas is extremely harmful, causing damage to the ozone layer and contributing to global warming.

So anaesthetists at East Suffolk and North Essex NHS Foundation Trust (ESNEFT) have stopped using it and are opting for greener alternatives.

Parents-to-be can be reassured nitrous oxide, known as entonox or gas and air when used in childbirth, can still be used during labour as a form of pain relief.

Woman in blue scrubs
Dr Kate Gardner

Dr Kate Gardner is a consultant anaesthetist at Colchester Hospital. She said: “Nitrous oxide is incredibly damaging and has 300 times the global warming potential of carbon dioxide. It remains in the atmosphere for 114 years.

“It also has some unpleasant side effects including increasing postoperative nausea. It has been used as part of a traditional anaesthetic since the 1860s despite more favourable alternatives being available. In recent years the impact on global warming and climate change has come to the fore and many anaesthetists have stopped using it altogether.”

Nitrous oxide is responsible for 2% of the carbon footprint of the NHS and 75% of the anaesthetic gas footprint. Theatre teams have stopped using it as part of the commitment by the NHS to be carbon net zero by 2040.

Pipes coming from ceiling
The pipes into theatre at Colchester Hospital. The blocked off pipe was previously used for nitrous oxide.

Nitrous oxide is either piped into theatres from a bank of cylinders called a manifold, or used from cylinders attached to the anaesthetic machine, but a huge amount of the gas is wasted through leaks.

“Some studies show 95% wastage from the piped supply,” added Kate. “We made the decision to remove all piped nitrous oxide and dismantle the manifold. We have kept a cylinder supply for our two delivery suite anaesthetic machines, where we may still use it for limited cases. As a department we want to embrace change and a number of anaesthetists have altered practice to enable this to happen. We should all be very proud and hopefully other hospitals will follow our example.”

Desflurane is another anaesthetic agent that has been removed at Colchester and Ipswich Hospitals to improve their commitment to more sustainable ways of working.

Close up of man with glasses
Dr Aaron Pennell

Dr Aaron Pennell is the acting consultant anaesthetist and clinical lead for Anaesthetics at Ipswich Hospital. He said: “Our new operating theatre suite at Ipswich no longer has piped nitrous oxide and we are now in the process of dismantling the nitrous oxide manifold at Ipswich Hospital that serves all other operating theatres.

“These measures, collectively with other NHS hospitals, will contribute to our long-term sustainability programme.”

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