Environmental impact of commonly used anaesthetic agents: systematic literature review with narrative synthesis

作者：Philippa Lloyd, Alexander J. Fowler, Anna Maria Wozniak, William Rattenberry, Sara Scott, Vikas Tripurneni, Mark Earl, Rupert M. Pearse, Sarah-Louise Watson, Tom Abbott, Sarah Hare · 发表于：BJA Open · 年份：2024 · DOI：10.1016/j.bjao.2024.100362 · 被引用次数：11 · 研究领域：Climate Change and Health Impacts、Pharmaceutical and Antibiotic Environmental Impacts、Chemistry and Chemical Engineering

Background: Increasing awareness of the potential environmental impact of volatile anaesthetic agents has stimulated increased use of total i.v. anaesthesia. However, consolidated comparative evidence of the environmental impact of anaesthetic agents across the whole life cycle is lacking. Methods: We performed a systematic review and narrative evidence synthesis of the environmental impact of anaesthetic agents stratified by drug life cycle. We searched MEDLINE (PubMed), Excerpta Medica dataBASE (EMBASE), Cumulative index to nursing and allied health literature (CINAHL), and DrugBank, from inception until 05 March 2023, for studies describing the environmental impact of anaesthetic drugs on the WHO essential medicine list. Independent review and data extraction were performed by pairs of reviewers. Data on any aspect of cradle-to-grave life cycle analysis were reported, with narrative synthesis grouped according to life cycle domains. Results: From 15 229 records, 42 unique reports met our inclusion criteria. The predominant environmental impact of inhalation anaesthetic agents is atmospheric release, contributing to global warming. This may be improved with the emergence of more efficacious scavenging and capture systems. Packaging and waste contributed most to the environmental impact of i.v. anaesthetic agents. There is increasing concern over the ecological impact of i.v. agents entering water sources, either by disposal of unused medication or through the excretion of d...