The issue has been stalled for some time, and to get things moving, the Collège des médecins du Québec (CMQ) is asking Santé Québec to stop the use of polluting anesthetic gases that are still used in surgery in the health network.
In a statement released Wednesday morning, the CMQ urged Santé Québec to stop the use of desflurane and to shut down nitrous oxide lines in health facilities.
These two anesthetic gases have a high environmental footprint. Compared to sevoflurane, desflurane’s carbon footprint is 40 times higher. As for nitrous oxide, it has a half-life of 109 years in the atmosphere.
The Collège des médecins du Québec emphasizes that inhaled anesthetic gases contribute significantly to greenhouse gas emissions from the healthcare system. It argues that eliminating the most polluting agents could be done quickly and that there is scientific evidence that this would reduce the environmental footprint of the healthcare system.
At the request of the Quebec Association of Anesthesiologists, the Ministry of Health and Social Services entrusted the National Institute of Excellence in Health and Social Services (INESSS) with the mandate to formulate recommendations on best clinical practices to be implemented to reduce the carbon footprint of general inhalation anesthesia.
In the summer of 2024, INESSS published an opinion recommending the closure of centralized nitrous oxide distribution systems by shutting off the supply to the pipelines. It also recommended that desflurane be removed from the provincial list of medications, which has still not been done.
The CMQ supports the INESSS (Institut de l’enseignement supérieur et de la santé) clinical recommendations. In its press release, it states that there is an “urgent need to act by making a rapid and structured shift towards more sustainable anesthetic practices.” It adds that the withdrawal of desflurane and the reduction of nitrous oxide do not compromise patient safety.
The president of the CMQ, Dr. Mauril Gaudreault, argued in writing that the College’s mandate to protect the public is linked to good environmental practices in healthcare.
“As a committed player in sustainable health, the College supports anesthetic practices with a lower environmental impact, in accordance with the evidence. That is why we are asking Santé Québec to take action to ensure that two polluting gases are gradually phased out. We will make representations to this effect to the government,” said Dr. Gaudreault.
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