Zero Hero

Reducing direct emissions by eliminating Desflurane use

Trust: East Sussex Healthcare NHS Trust
Location: Trust-wide 
Name and role: Nicola Deacy, Consultant Anaesthetist

Image of Nicky Deacy in clinical setting

What did Nicky do?

Nicky led the charge to eliminate the use of the Volatile Anaesthetic Gas, Desflurane, across the Trust. This required education of staff to understand the environmental impacts of Desflurane, an empowering staff to explain their choice of anaesthetic to patients. Nicky fostered a culture change with regards to Desflurane use, eliminating it's use completely in 2023.

Due to the impacts of Desflurane, NHS England have set a national target for all Desflurane use to be eliminated by April 2024.

Why it matters?

Desflurane has been widely used across the NHS for many years due to its advantages supporting long operations and high BMI patients. It has very quick onset and offset, making it safe and convenient for patient and anaesthetist.

However, when in use, Desflurane is released directly into our atmosphere and research shows that Desflurane has a huge Greenhouse Gas effect, 2500 times greater than that of carbon dioxide!

Medical gas emissions typically account for 5% of an NHS Trust's entire carbon footprint, therefore changing to more sustainable alternatives is critical.

A 1-hour operation using Desflurane releases emissions equivalent to driving 200-400km in an average car. By switching to Sevoflurane, that number falls to 5-10km. Better still, Total Intravenous Anaesthetics (TIVA) can be used without any direct release of Greenhouse Gas.

Graph showing Desflurane usage at ESHT from 2018 to present
Graph showing Desflurane usage at ESHT from 2018 to present

Figure 1. Emissions from volatile anaesthetic gases (tCO2e)
Carbon equivalent emissions (tCO2e) from Desflurne used by ESHT (Note: this includes waste and returns).

Why Nicky is a Zero Hero

Over the past 4 years, Nicky has been working to reduce Desflurane use within the Trust. Related emissions peaked in March 2019 at 52.56 tonnes of CO2e. This is equivalent to around 50 flights from London to New York, in one month alone!

The above graph shows the dramatic reduction in emissions of harmful greenhouse gases and the extraordinary impact of Nicky's efforts.

Fast forward to June 2023 and no Desflurane was used and related processes and formularies have been updated to block the future purchase or use of this anaesthetic.


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