Toxicity of anesthetic gases: exposure in operating rooms and influence on the environment.

Maciej Bara; Agata Janczak

doi:10.56782/pps.157

Published : 2023-07-26

Vol. 21 No. 3 (2023)

Toxicity of anesthetic gases: exposure in operating rooms and influence on the environment

Maciej Bara

Agata Janczak

DOI: https://doi.org/10.56782/pps.157

Abstract

Nitrous oxide, sevoflurane, isoflurane and desflurane are commonly used to provide anesthesia during surgical procedures. However, usage of inhaled anesthetics is not without its risks. Occupational exposure to those gases might have a harmful effect on medical personnel working not only at operating theaters, but also on post-operative wards and intensive care units. Long term exposure to volatile anesthetics may lead to liver and kidney damage and elevated plasma inflammatory markers. Episodes of miscarriage, preterm birth or congenital malformations have been observed in pregnant women. Neurotoxicity of these drugs also has been evidenced by recent studies. What is more, anesthetics are greenhouse gases that contribute to the climate crisis. Some of the gaseous anesthetics stay in the atmosphere for even 114 years after being released from the hospital environment. The aim of this paper is to review the dangers of occupational exposure to inhaled anesthetics and their impact on the environment, as well as to take a closer look at alternatives that could potentially replace the use of gaseous anesthetics.

Keywords:

environment toxicity, anesthetic gases, occupational risk

Most read articles by the same author(s)

Adam Piasecki, Magdalena Sitnik, Jakub Olszewski, Maciej Bara, Katarzyna Herjan, Piotr Armański, The changing landscape of mineralocorticoid receptor antagonists – finerenone in cardiovascular and renal health , Prospects in Pharmaceutical Sciences: Vol. 22 No. 1 (2024)

Details

References

Statistics

Authors

Download files

PDF (Język Polski)

Citation rules

Bara, M., & Janczak, A. (2023). Toxicity of anesthetic gases: exposure in operating rooms and influence on the environment. Prospects in Pharmaceutical Sciences, 21(3), 1–5. https://doi.org/10.56782/pps.157

Altmetric indicators

Cited by / Share

Licence

This work is licensed under a Creative Commons Attribution 4.0 International License.

References

World federation of societies of anaesthesiologists, “History of anaesthesia”. Available from: https://wfsahq.org/about/history/history-of-anaesthesia/ (accessed on 10 July 2023).

Rübsam ML, Kruse P, Dietzler Y, Kropf M, Bette B, Zarbock A, Kim SC, Hönemann C. A call for immediate climate action in anesthesiology: routine use of minimal or metabolic fresh gas flow reduces our ecological footprint. Can J Anaesth. 2023;70(3):301-312. doi: 10.1007/s12630-022-02393-z. DOI: https://doi.org/10.1007/s12630-022-02393-z

American Society of Anesthesiologists. Avaliable from: https://www.asahq.org/about-asa/newsroom/news-releases/2022/06/reduce-carbon-footprint-from-inhaled-anesthesia-with-new-guidance-published (accessed on 22 June 2022).

Drugbank online. Available from: https://go.drugbank.com/drugs/DB01189 (accessed on 24 July 2023).

Larsen, współpraca Thorsen Annecke, Tobias Fink, redakcja wydania polskiego Andrzej Kübler, Anestezjologia tom 1, wydanie polskie IV.; Elsevier Urban & Partner, Wrocław, Polska, 2020; p 18.

Kayla Knuf; Christopher V. Maani. Nitrous Oxide. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Sep 7. Available from https://www.ncbi.nlm.nih.gov/books/NBK532922/ (accessed on 10 July 2023).

Drugbank online. Available from: https://go.drugbank.com/drugs/DB06690 (accessed on 24 July 2023).

Trevor L. Edgington; Erind Muco; Christopher V. Maani. Sevoflurane StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jun 11. Available from https://www.ncbi.nlm.nih.gov/books/NBK534781/ (accessed on 10 July 2023].

Drugbank online. Available from: https://go.drugbank.com/drugs/DB01236/. (accessed on 24 July 2023).

Drugbank online. Available from: https://go.drugbank.com/drugs/DB00753 (accessed on 24 July 2023).

EMA. Charakterystyka Produktu Leczniczego Suprane. Avaliable from: http://chpl.com.pl/data_files/2012-02-09_suprane_spc_1x240_ml.pdf (accessed on 24 July 2023).

Joohi Khan; Mark Liu. Desflurane. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jun 11. Available from https://www.ncbi.nlm.nih.gov/books/NBK537106/ (accessed on 10 July 2023).

Keller M, Cattaneo A, Spinazzè A, Carrozzo L, Campagnolo D, Rovelli S, Borghi F, Fanti G, Fustinoni S, Carrieri M, Moretto A, Cavallo DM. Occupational Exposure to Halogenated Anaesthetic Gases in Hospitals: A Systematic Review of Methods and Techniques to Assess Air Concentration Levels. Int J Environ Res Public Health. 2022; 20(1):514. doi: 10.3390/ijerph20010514. DOI: https://doi.org/10.3390/ijerph20010514

Neghab M, Amiri F, Soleimani E, Yousefinejad S, Hassanzadeh J. Toxic responses of the liver and kidneys following occupational exposure to anesthetic gases. EXCLI J. 2020;19:418-429. doi: 10.17179/excli2019-1911. Erratum in: EXCLI J. 2021 Feb 15;20:338.

Al-Rasheedi KA, Alqasoumi AA, Emara AM. Effect of inhaled anaesthetics gases on cytokines and oxidative stress alterations for the staff health status in hospitals. Int Arch Occup Environ Health.; 2021;94(8):1953-1962. doi: 10.1007/s00420-021-01705-y. Epub 2021 May 6. DOI: https://doi.org/10.1007/s00420-021-01705-y

Marsters CM, Stafl L, Bugden S, Gustainis R, Nkunu V, Reimer R, Fletcher S, Smith S, Bruton Joe M, Hyde C, Dance E, Ruzycki SM. Pregnancy, obstetrical and neonatal outcomes in women exposed to physician-related occupational hazards: a scoping review. BMJ Open. 2023; 13(2):e064483. doi: 10.1136/bmjopen-2022-064483. DOI: https://doi.org/10.1136/bmjopen-2022-064483

Boivin JF. Risk of spontaneous abortion in women occupationally exposed to anaesthetic gases: a meta-analysis. Occup Environ Med.; 1997; 54(8):541-8. doi: 10.1136/oem.54.8.541. DOI: https://doi.org/10.1136/oem.54.8.541

Lucchini R, Placidi D, Toffoletto F, Alessio L. Neurotoxicity in operating room personnel working with gaseous and nongaseous anesthesia. Int Arch Occup Environ Health. 1996; 68(3):188-92. doi: 10.1007/BF00381630. DOI: https://doi.org/10.1007/BF00381630

Varughese S, Ahmed R. Environmental and Occupational Considerations of Anesthesia: A Narrative Review and Update. Anesth Analg. 2021; 133(4):826-835. doi: 10.1213/ANE.0000000000005504. DOI: https://doi.org/10.1213/ANE.0000000000005504

Köner Ö. Anesthetic Gases Do Harm to the Environment, Is It Time for a Change? Turk J Anaesthesiol Reanim. 2022; 50(1):6-7. doi: 10.5152/TJAR.2022.7222. DOI: https://doi.org/10.5152/TJAR.2022.7222

Koch S, Pecher S. Neue Herausforderungen für die Anästhesie durch den Klimawandel [New challenges for anesthesia due to the climate change]. Anaesthesist. 2020; 69(7):453-462. German. doi: 10.1007/s00101-020-00770-1. Erratum in: Anaesthesist. 2020 Jul 3. DOI: https://doi.org/10.1007/s00101-020-00770-1

Yasny JS, White J. Environmental implications of anesthetic gases. Anesth Prog.; 2012; 59(4):154-8. doi: 10.2344/0003-3006-59.4.154. DOI: https://doi.org/10.2344/0003-3006-59.4.154

Ishizawa Y. Special article: general anesthetic gases and the global environment. Anesth Analg. 2011 ;112(1):213-7. doi: 10.1213/ANE.0b013e3181fe02c2. Epub 2010 Nov 3. DOI: https://doi.org/10.1213/ANE.0b013e3181fe02c2

World Federation of Societies of Anaesthesiologists, “Moving Towards Green Anaesthesia - Strategies for Environmental Sustainability”. Available from: https://resources.wfsahq.org/atotw/moving-towards-green-anaesthesia-strategies-for-environmental-sustainability/ (accessed on 11 July 2023).

Green Anaesthesia Scotland. Available from: https://www.greenanaesthesia.scot/. (accessed on 11 July 2023).