Anaesthetic subspecialties and sustainable healthcare: a narrative review

Oliver, C., Charlesworth, M., Pratt, O., Sutton, R. and Metodiev, Y. ORCID: https://orcid.org/0000-0003-0347-4693 2024. Anaesthetic subspecialties and sustainable healthcare: a narrative review. Anaesthesia: Peri-operative medicine, critical care and pain 79 (3) , pp. 301-308. 10.1111/anae.16169

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Abstract

Summary: The principles of environmentally sustainable healthcare as applied to anaesthesia and peri‐operative care are well documented. Associated recommendations focus on generic principles that can be applied to all areas of practice. These include reducing the use of inhalational anaesthetic agents and carbon dioxide equivalent emissions of modern peri‐operative care. However, four areas of practice have specific patient, surgical and anaesthetic factors that present barriers to the implementation of some of these principles, namely: neuroanaesthesia; obstetric; paediatric; and cardiac anaesthesia. This narrative review describes these factors and synthesises the available evidence to highlight areas of sustainable practice clinicians can address today, as well as posing several unanswered questions for the future. In neuroanaesthesia, improvements can be made by undertaking awake surgery, moving towards more reusables and embracing telemedicine in quaternary services. Obstetric anaesthesia continues to present questions regarding how services can move away from nitrous oxide use or limit its release to the environment. The focus for paediatric anaesthesia is addressing the barriers to total intravenous and regional anaesthesia. For cardiac anaesthesia, a significant emphasis is determining how to focus the substantial resources required on those who will benefit from cardiac interventions, rather than universal implementation. Whilst the landscape of evidence‐based sustainable practice is evolving, there remains an urgent need for further original evidence in healthcare sustainability targeting these four clinical areas.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Schools > Medicine
Additional Information:	License information from Publisher: LICENSE 1: URL: http://creativecommons.org/licenses/by-nc-nd/4.0/
Publisher:	Wiley
ISSN:	0003-2409
Date of First Compliant Deposit:	18 January 2024
Date of Acceptance:	3 October 2023
Last Modified:	17 Apr 2024 01:22
URI:	https://orca.cardiff.ac.uk/id/eprint/165632

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