# Carbon footprint in trauma surgery, is there a way to reduce it?

## TL;DR

This study shows that using regional anesthesia instead of general anesthesia in trauma surgeries can significantly reduce the carbon footprint from inhaled anesthetics like sevoflurane.

## Contribution

The study quantifies the environmental benefits of regional anesthesia in trauma surgery and compares complication rates.

## Key findings

- Switching to regional anesthesia could reduce sevoflurane use by 92k, equivalent to 406,553 km of car driving.
- General anesthesia had a higher complication rate (7.7%) compared to regional (6.9%), though the difference was not statistically significant.
- Most trauma surgeries (95%) were performed under general anesthesia, indicating a potential for environmental improvement.

## Abstract

Inhaled anaesthetic agents like sevoflurane contribute for approximately 5% to healthcare’s carbon footprint. Previous studies suggested that the use of these agents should be minimized. Although multiple trauma surgeries can be performed under regional anaesthesia, most are performed under general anaesthesia. This study aims to evaluate the environmental benefits of using regional anaesthesia over general anaesthesia and to compare the associated complication rates.

This retrospective study included all trauma patients (≥ 18 years) who underwent surgical intervention for hand, wrist, hip, or ankle fractures from 2017 to 2021. The hypothetical environmental gain was calculated based on the assumption that all surgeries were performed under regional anaesthesia. Complication rates were compared between regional and general anaesthesia.

Of the 2,714 surgeries, 15% were hand, 26% wrist, 36% hip, and 23% ankle fractures. General anaesthesia was used in 95%, regional in 5%. Switching this 95% to regional anaesthesia would reduce the sevoflurane use by 92 k, comparable to driving 406,553 km by car. The complication rate was higher with general anaesthesia compared to regional (7.7% vs 6.9%, p = 0.75).

The potential gain of the reduction of sevoflurane in trauma surgeries which can be performed under regional anaesthesia can be significant.