SHTG recommendation

In response to enquiry from the Health Infrastructure Division.

What were we asked to look at

The Scottish Government’s Health Infrastructure Division asked SHTG to independently evaluate the use of VCTs in anaesthetic rooms and operating theatres. The intended purpose of VCTs is to reduce anaesthetic volatile gas emissions (greenhouse gases) entering the atmosphere and contributing to global warming and climate change.

Why is this important

The gases that are used for anaesthetics and pain relief are greenhouse gases, and include the volatile gases desflurane, sevoflurane and isoflurane. Volatile gases are defined as those that evaporate readily at normal temperatures. Reducing the environmental impact of anaesthetic gases has been highlighted by the Scottish Government as a key priority.

Desflurane, isoflurane and sevoflurane are reported as having 100-year time horizon global warming potentials (GWP100) that are respectively 2,540, 510 and 130 times more potent than carbon dioxide. Some climate experts suggest these figures are misleading, and that the impact of these gases on climate change is insignificant because the lifetimes of the gases are too short and the concentrations are too low to have a meaningful environmental impact. In NHSScotland an 82% reduction in volatile gas emissions was achieved over the period of 2018/19 to 2021/22 as a result of various mitigation measures (for example, low flow anaesthetic techniques and switching from desflurane to sevoflurane).

An impartial assessment of VCTs was requested to establish whether the purchasing, installation and maintenance of VCTs offers good value for money and whether they provide net environmental benefit.