Scotland NHS ban Desflurane Anesthetic….why should you care? You should.

[deema]

The main substitute for Desflurane is Sevoflurane, however, medically Sevoflurane cannot be used with a huge list of other drugs compared with Desflurane, it also has a lot more side effects. This is some of the reasons why Desflurane was so popular, and who I believe it’s a retrograde step banning it.

Sevoflurane is still a greenhouse gas, but one of the better ones.

https://www.mayoclinic.org/drugs-su...nhalation-route/side-effects/drg-20063377?p=1
https://www.mayoclinic.org/drugs-su...nhalation-route/side-effects/drg-20065933?p=1
Now, putting how bad Desflurane is to the planet into perspective, it’s about twice as bad as Nitros Oxide, laughing gas. The stuff that kids are misusing for recreational pleasure. It’s also the main pain killer used for child birth, found in the back of ambulances to help pain management, and many other clinical situations. It is also used in the food industry to propel and foam such things as an example, whipped cream. To put it bluntly, I can see a value in stopping Nitrous Oxide being banned in food, or available in small canisters that kids misuse, or indeed to add extra HP for drag cars. All of which will use and add far more green house gases than any of the medical uses of the anaesthetics we presently have. This is why I believe the report on banning Desflurane is political rather than medically driven.

Here is a nice article from the Royal College of Anaesthetists about Anaesthetics and their green house gas equivalents

https://rcoa.ac.uk/patient-informat...rioperative-care/your-anaesthetic-environment

 

[Jacob]

....... This is why I believe the report on banning Desflurane is political rather than medically driven.

For what political purpose, and why this particular anaesthetic?

 

[Spectric]

Britain is still a wealthy and powerful country in world terms, in spite of brexit.

Yes it may be wealthy but most of that wealth is owned by a small minority, the majority just work to live. Our military is more hype than anything else and I doubt many other countries really view the Uk as something to behold, the days of the empire and our industries ruling the world in terms of exporting goods are long gone. We are really nothing on the world stage, we have had our turn and now we need to stand back and let others take the lead. I think the biggest break throughs in green technology will come from the east, China is already a world leader in manufacturing and realises that to reach the top they need to clean up their act but it takes time. We are making changes and not actually weighing up the pro's and con's just reacting and I would have thought that if this anaesthetic was not so good at it's job then it would have been replaced by something else, so as @deema has said

The only ‘damming’ evidence against it is its supposed carbon footprint. Nobody has said there is a better more effective drug, only that others can be used.

so we end up using next best for no real reason, they would save more in pollutants by reducing cattle numbers and growing more food that we can eat rather than growing food to feed methane producing animals.

 

[deema]

For what political purpose, and why this particular anaesthetic?

Virtue signalling, they can’t ban all anaesthetics the population would understand the implications and not accept it. But, by banning what is perceived as the worst offender, they are ticking the box.

I suspect that in reality there is more than twice the volume of Nitrous Oxide used in the NHS than Desflurane, so if they wanted the biggest impact you would look at not only it’s green house effect, but also the quantity. However, for pain relief in say child birth banning it would cause a huge outcry. After all since the birth on man, until about 100 years ago, women gave birth naturally without pain relief; use of Nitrous! We would be saying come on girls suck up the pain, it’s a natural thing, your saving the planet for your kid.

 

[Jacob]

Virtue signalling,

Signalling to whom; "the woke" I presume?

I suspect that in reality there is more than twice the volume of Nitrous Oxide used in the NHS than Desflurane, ....

Desflurane has 25 times the warming effect of Nitrous oxide, according to figures bandied about above in this thread.
Anyway I'm out of this thread, it's dead in the water!

 

[deema]

Signalling to whom?


Desflurane has 25 times the warming effect of Nitrous oxide.

You’ve fallen into the typical trap of just looking at ‘scare’ numbers. For a 1 hour procedure you use a lot more Nitrous than you do Desflurane, the amount used makes it have a much lower affect. So, if you read the article from the Royal College of Anaesthetists it gives you the CO2 equivalence for a 1 hour procedure. Desflurane is used in very controlled situations with an anaesthetist present. So, not a lot in reality used. Nitrous on the other hand is used in loads of situations for pain relief, broken bones, child birth, ie it’s used a huge amount in comparison.

 

[Jacob]

You’ve fallen into the typical trap of just looking at ‘scare’ numbers. For a 1 hour procedure you use a lot more Nitrous than you do Desflurane. So, if you read the article from the Royal College of Anaesthetists it gives you the CO2 equivalence for a 1 hour procedure. Desflurane is used in very controlled situations with an anaesthetist present. So, not a lot in reality used. Nitrous on the other hand is used in loads of situations for pain relief, broken bones, child birth, ie it’s used a huge amount in comparison.

Drop them a line and tell them! It's wasted on here. Best of luck, let us know how they reply.

 

[Kittyhawk]

If you like to see global warming in action, come to our place.
See water temperatures 2° above normal and as a result this summer, three severe tropical rain events and two cyclones. Billions of dollars of infrastructure damage, 20% of forests destroyed in the north island, entire low lying suburbs inundated and will probably have to be abandoned, hundreds of homes destroyed or rendered uninhabitable - the catastrophic list goes on and on.
As to whether global warming is man made or not, I have an opinion but I'm not a climate scientist so my opinion is not worth anything, just the same as everybody else's here.
But irrespective of that we have an obligation to care for our environment as best we can - as in you and me personally, not tut-tutting about what him down the road should be doing. For us that means walking or cycling when we want to go someplace that's not too far away. For us it means turning off lights and appliances not currently in use. Figures in NZ show that if we all did that we would have a huge over supply in generating capacity. For us it means not wanting all the latest gear. The fashion and tech industries are among the world's major polluters. For us it means unwrapping small purchases in-store telling the sales person you only want the product, not the acres of blister pack packaging it comes in. Hopefully this gets back to the manufacturers.
If we all did this, would it make a difference to our climate? Dont know, I'm not a scientist but it sounds like the right thing to do. But what I can guarantee you is that it will have a very positive effect on your health and on your bank balance.

 

[Spectric]

Desflurane has 25 times the warming effect of Nitrous oxide

But is only used in a medical enviroment, Nitrous oxide is being abused on a huge scale and without any control so overall is causing far greater issues than any anaesthetic but as has been mentioned targeting something that is of value to people will deliver more brownie points but they just don't realise no one is counting.

 

[Swiftedge]

Do you think you might have some bias from the time? The company would have been singing the drugs praises to encourage it, the hospitals would likely have gotten a deal to use it and once committed would have also promoted it. I'd imagine most working on drug delivery systems are told how important their work is and have a strong belief in it.
I'm sure your work has been hugely valuable and something to be proud of, just because evidence and perceptions change doesn't devalue what was done at the time.

I don't think political motivations and being put above health outcomes. Making improvements now will have huge long term benefits.

The NHS has other initiatives in carbon reduction:
https://www.england.nhs.uk/greenern...vering-a-net-zero-national-health-service.pdf
The inhaler manufacturers reactions to losing market share of their product in the UK, and probably across other European countries, has been to make commitments to using greener materials, develop new delivery devices and research greener gas propellents. In the meantime, until they launch better devices, they put money in to carbon offsetting projects.

Our country might be a smaller contributor to greenhouse gases, but the changes we make do have a wider impact. Even if manufacturers make changes for their own profit rather than true environmental concern, the new products will be sold worldwide.

 

[John Brown]

Now, I’m not medically trained, I’m not an anaesthetist or claim to have any specialist knowledge.

Me neither, but as soon as I read or hear "tree hugging loonies" I know I can safely ignore anything that follows.

 

[deema]

@Swiftedge There is always some bias on everyone, I’m sure I’m no exception. My work in this area was over 30 years ago, and I have done an awful lot in between that is more memorable

The number of new gas anaesthetics developed in the last thirty years is one I believe. That’s not indicative of the drugs company’s seeing lots of scope to develop new stuff. Anaesthetic drug development is both extremely expensive, 30 years ago it was well over a few billion just because your treating people with every ailment and need to be sure it doesn’t interact with other drugs they are taking as well as maintaining people alive when they are in lots of circumstances their most ill. It also takes decades of testing. To throw away one of about 5 known anaesthetic gases to me is a ridiculous decision, one of which; Halothane is no longer used in the west as it can have nasty side effects and is now only really used in the developing countries. Desflurane has specific advantages that no other anaesthetic matches.

 

[Jacob]

.......

Now, I’m not medically trained, I’m not an anaesthetist or claim to have any specialist knowledge.

Now you tell us!

....... Im also retired so have no agenda.

Except being a climate change sceptic? Using terms like "virtue signalling" , or "tree hugging" are strong indicators. Surprised you haven't mentioned "woke" etc.

.... So what if it adds a bit to global warming, it’s benefits far exceed any downside and the green tree hugging loonies need to understand what stupidity they are inflicting on all of us.

Yep that seems to be it.
You have a bit of catching up to do in another area where perhaps you also have no "specialist knowledge".
It's never too late!
n.b. it's general knowledge now and there's plenty of information available.
https://www.un.org/en/climatechange/what-is-climate-change

 

[deema]

@Jacob Environmental issues are important your right, and it’s vital we all focus on what is important and has a real affect. Now, I’ve mentioned the WWW and turning off your computer to help the environment, I suspect that may have come over as being a little sarcastic, however, it was actually a real point. Data centres are estimated to use about 1.2% of the total world electricity in 2021 and is exponentially increasing. Clearly the WWW is highly valued by everyone, but it’s also used flippantly for trivial stuff. Let’s take Facebook, which many use and is just one of the social media platforms. It used 7 Tera Watt hours, that’s a huge amount. Putting it into context a large on shore wind turbine generated around 2~3 Mega Watts of power, enough to support around 1,500 homes. You can do the maths for the size of the forest of wind turbines needed just to power Facebook. Or, if your a nuclear fan, typically a nuclear power p,any generates only 1 giga watt of power a year, so, again you need to build a shed load of them just to power Facebook.

This is one of the many reasons that it appear that the public and governments are playing lip service to global warming. Turning off social media will have singularly one of the biggest effects.

 

[Jacob]

@Jacob Environmental issues are important your right, and it’s vital we all focus on what is important and has a real affect. Now, I’ve mentioned the WWW and turning off your computer to help the environment, I suspect that may have come over as being a little sarcastic, however, it was actually a real point. Data centres are estimated to use about 1.2% of the total world electricity in 2021 and is exponentially increasing. Clearly the WWW is highly valued by everyone, but it’s also used flippantly for trivial stuff. Let’s take Facebook, which many use and is just one of the social media platforms. It used 7 Tera Watt hours, that’s a huge amount. Putting it into context a large on shore wind turbine generated around 2~3 Mega Watts of power, enough to support around 1,500 homes. You can do the maths for the size of the forest of wind turbines needed just to power Facebook. Or, if your a nuclear fan, typically a nuclear power p,any generates only 1 giga watt of power a year, so, again you need to build a shed load of them just to power Facebook.

This is one of the many reasons that it appear that the public and governments are playing lip service to global warming. Turning off social media will have singularly one of the biggest effects.

View attachment 154455

You are right of course to express scepticism about govt activity on climate change.
But just holding your hands up and deriding efforts being or not being made is not enough; if you are serious about it the ballot box is the place to go and vote green at the next election.
Join in and take an active part - it's not all tree hugging!

 

[Spectric]

Turning off social media will have singularly one of the biggest effects.

As I have said the data centres are consuming huge amounts of energy, that is just facebook so now add them all up and the WWW. This level of energy consumption cannot be offset by the UK not using a brand of anaesthetic and I doubt if we all dumped our cars tommorow and used bicycles it would still not be enough so really the UK actions are nothing more than peeing in the ocean and trying to raise sea levels.

 

[Jameshow]

As I have said the data centres are consuming huge amounts of energy, that is just facebook so now add them all up and the WWW. This level of energy consumption cannot be offset by the UK not using a brand of anaesthetic and I doubt if we all dumped our cars tommorow and used bicycles it would still not be enough so really the UK actions are nothing more than peeing in the ocean and trying to raise sea levels.

Certainly would be a "knock out" blow though!

 

[Sean33]

This will just be another issue for the Uk, we don't seem to comprehend our global position and the fact that changes we make have very little global impact because if you are only contributing a very small perecentage in the first place then even with total removal the effects are negligable.

We are basically destroying ourselves and infrastructure for no reason, what is the true impact of this Desflurane Anaesthetic ? Is it anywhere near as bad as the Ozone depleting refrigerants or methane from cattle.

China has more than 1100 coal fired power stations yet we have just three having closed dozens and now we get the huge energy bills, so what will the impact of not having this Anaesthetic available in the Uk, I dare say it will still be used in most other countries though.

Just like the far East and other emerging countries will continue to use fossil fuels and Seemingly not give two hoots about climate change whilst they build their infrastructure to make everything we need. Unless the entire world agrees to change which is penalised for not adhering to we will continue to become irrelevant.. sorry if I have hijacked the thread, Rant over !

 

[Jacob]

Just like the far East and other emerging countries will continue to use fossil fuels and Seemingly not give two hoots about climate change whilst they build their infrastructure to make everything we need.

China is going green faster than anybody.

Unless the entire world agrees to change which is penalised for not adhering to we will continue to become irrelevant.. sorry if I have hijacked the thread, Rant over !

Almost the entire world has agreed.
https://www.un.org/en/climatechange/paris-agreement

 

[Sean33]

China is going green faster than anybody.

The entire world has agreed.
https://www.un.org/en/climatechange/paris-agreement

Yes everybody agreed, in theory but who is actually abiding by it. Think it was 20 odd new coal plants last yr and other 30 planned for this, and I am not just having a go at China that is also true of other emerging markets. I have a friend that works at the UN amongst other places, infinitely more informed than me, yes what they say looks great but what is happening on the ground is another issue entirely. Another example is moving production to neighbouring countries, great for employment but the infrastructure is just not there, and what is the quickest and cheapest way to achieve this