The future is now—it’s time to rethink the application of the Global Warming Potential to anesthesia

Excerpt

All volatile anesthetic agents are fluorocarbons and variably potent greenhouse gases (GHG).1 As a chlorofluorocarbon (CFC), isoflurane also has ozone depleting potential (as does nitrous oxide [N₂O]), while sevoflurane and desflurane, being hydrofluorocarbons (HFC), do not.1 The global emission of HFCs increased 128% from 1990 to 2005 and is projected by 2030 to increase a further 336% compared with 2005 emissions.2 The Montreal Protocol is an international treaty agreed upon in 1987 with the primary goal to protect the ozone layer and to reverse the ozone hole over Antarctica.1 While it is being heralded as a major multinational success, since it has led to the phase-out of CFCs3 and a subsequent slow recovery of the ozone layer, it has led to an increased use of HFCs, which are also very potent GHGs. The 2016 Kigali amendment to the Montreal Protocol further aims to phase-down those HFCs with a high potential for contributing to global warming.1 Unfortunately, the field of anesthesia finds itself in a unique position where the release of its CFCs and HFCs has actually increased over time. …