Increased use of regional anesthesia instead of general anesthesia may help reduce greenhouse gas emissions that contribute to climate change (Choice of Anesthesia), according to researchers at the Hospital for Special Surgery in New York City. Unlike general anesthesia, the choice of regional anesthesia doesn’t use volatile halogenated agents, such as desflurane or nitrous oxide. These are greenhouse gases that can remain in the atmosphere for up to 114 years, the researchers noted.

“Increasing the use of regional anesthesia is potentially good for the climate, improves the quality of care (at least for hip and knee replacements), and may allow individual practitioners to take personal responsibility in the fight against global warming,” said Dr. Christopher Wu, an anesthesiologist at a hospital, and colleagues

In 2019, the hospital decided to use regional anesthesia in as many hip and knee replacements as possible. Of the 10,485 such procedures performed that year, only 4% used general anesthesia.

The hospital’s increased use of regional anesthesia saved the equivalent of nearly 27,000 pounds of coal burned, 2,750 gallons of gas, 60,500 car miles, or 3.1 million smartphones charged, according to the study authors.

In 2009, there were more than one million hip and knee replacement procedures in the United States. The researchers calculated that if all of these were done under general anesthesia, that would have resulted in 112,000 kg (nearly 247,000 pounds) of desflurane and 9,000 kg (about 20,000 pounds) of nitrous oxide released into the atmosphere.

That’s equivalent to the greenhouse emissions generated by 3.2 million pounds of coal burned, or 333,000 gallons of gas used, 7,350,000 car miles, or 378 million smartphones charged, they said.

The study was published June 16 in the journal Regional Anesthesia & Pain Medicine.

“Increasing the use of regional anesthesia is potentially good for the climate, improves the quality of care (at least for hip and knee replacements), and may allow individual practitioners to take personal responsibility in the fight against global warming,” said Dr. Wu and colleagues. “This certainly is not a complete analysis, as we have not calculated how the manufacture of regional anesthetic agents or the impact of the plastics involved in regional anesthetic kits might affect the earth compared with volatile anesthetics,” they noted. The authors also acknowledged that not all surgeries can easily be switched to regional anesthesia.