RESUMO
OBJECTIVE: The use of volatile anesthetics plays an important role in the production of greenhouse gases and other environmental pollutants that negatively affect global health. Programs to reduce anesthesia contaminants have been shown to be effective and reduce costs. For this reason, we conducted a study to implementing a Zero Emissions Program for zero carbon dioxide emissions derived from anesthetic gases used in the operating room, as recommended by the Green Deal of the European Union by 2030 and be climate neutral in 2050, maintaining satisfaction and current clinical results. METHODS: A Zero Emissions Program was implemented within the Zero safety programs of the Cruces University Hospital in order to produce zero emissions of carbon dioxide derived from the anesthetic gases used in the operating rooms. The contribution of anesthetic gases to carbon dioxide production before and after implementation of program was determined. Data analysis was conducted descriptively to analyze program effectiveness. RESULTS: The implementation of a Zero Emissions Program allowed us to achieve a reduction in emissions to zero. CONCLUSIONS: Anesthesiologists must understand that minimizing our harmful impact on environmental health sustainability is not only desirable, but ethically necessary. A way to contribute to this ethical responsibility is Zero Emissions Programs which are effective in reducing emissions to zero, probably improving our impact on planet health.
OBJETIVO: El uso de anestésicos volátiles juega un papel importante en la producción de gases de efecto invernadero y otros contaminantes ambientales que afectan negativamente a la salud mundial. Se ha demostrado que los programas para reducir los contaminantes de la anestesia en el medio ambiente son eficaces y también reducen los costes. Por este motivo nos planteamos como objetivo implementar un Programa de Emisiones Zero para producir cero emisiones de dióxido de carbono derivados de los gases anestésicos utilizados en el quirófano, como recomienda el Pacto Verde de la Unión Europea, para 2030 y ser climáticamente neutros en 2050, manteniendo la satisfacción y los resultados clínicos actuales. METODOS: Se implementó un Programa de Emisiones Zero dentro de los programas Zero de seguridad del Hospital Universitario de Cruces (Barakaldo) con la finalidad de producir cero emisiones de dióxido de carbono derivado de los gases anestésicos utilizados en los quirófanos. Se determinó la contribución de los gases anestésicos a la producción de dióxido de carbono previo y posterior a la implementación del programa. El análisis de los datos se llevó a cabo de forma descriptiva para analizar la efectividad del programa. RESULTADOS: La implementación de un Programa de Emisiones de Zero nos permitió conseguir una disminución de las emisiones a cero. CONCLUSIONES: Los anestesiólogos debemos comprender que minimizar nuestro impacto nocivo en la sostenibilidad de la salud ambiental no es solo deseable, sino éticamente necesario. Una de las formas de contribuir con esta responsabilidad ética es con la implementación de Programas de Emisiones Zero que son eficaces en la reducción a cero de estas emisiones con lo que mejoraremos nuestro impacto en la salud del planeta.
Assuntos
Poluição do Ar , Anestésicos Inalatórios , Humanos , Espanha , Dióxido de Carbono/análise , Efeito Estufa , Poluição do Ar/prevenção & controle , HospitaisRESUMO
BACKGROUND: Non-steroidal anti-inflammatory drugs are often used as components of multimodal therapy for postoperative pain management, but their use is currently limited by its side effects. The specific objective of this study was to evaluate the efficacy and safety of a new formulation of intravenous (IV) ibuprofen for the management of postoperative pain in a European population. METHODS AND FINDINGS: A total of 206 patients from both abdominal and orthopedic surgery, were randomly assigned in 1:1 ratio to receive 800 mg IV-ibuprofen or placebo every 6 hours; all patients had morphine access through a patient controlled analgesia pump. The primary outcome measure was median morphine consumption within the first 24 hours following surgery. The mean±SEM of morphine requirements was reduced from 29,8±5,25 mg to 14,22±3,23 mg (p = 0,015) and resulted in a decrease in pain at rest (p = 0,02) measured by Visual Analog Scale (VAS) from mean±SEM 3.34±0,35 to 0.86±0.24, and also in pain during movement (p = 0,02) from 4.32±0,36 to 1.90±0,30 in the ibuprofen treatment arm; while in the placebo group VAS score at rest ranged from 4.68±0,40 to 2.12±0,42 and during movement from 5.66±0,42 to 3.38±0,44. Similar treatment-emergent adverse events occurred across both study groups and there was no difference in the overall incidence of these events. CONCLUSIONS: Perioperative administration of IV-Ibuprofen 800 mg every 6 hours in abdominal surgery patient's decreases morphine requirements and pain score. Furthermore IV-Ibuprofen was safe and well tolerate. Consequently we consider appropriate that protocols for management of postoperative pain include IV-Ibuprofen 800 mg every 6 hours as an option to offer patients an analgesic benefit while reducing the potentially risks associated with morphine consumption. TRIAL REGISTRATION: EU Clinical Trials Register 2011-005007-33.