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Greenhouse gas |
· Substance that absorbs and emits infrared radiation · e.g. CO2, N2O, methane, ozone |
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Anthropogenic global warming |
· Warming of average temperatures on earth caused by greenhouse emissions arising from human activity · Many detrimental environmental effects |
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Ozone layer |
· O3 rich region in the stratosphere · Absorbs UV-B |
(descending order of toxicity)
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Desflurane |
· Direct AGW: 6 hours at Fi 7% ≈ 1000kmg driving · 0.02% metabolised; also resistant to environmental breakdown · Greater impact mostly due to long half life |
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Nitrous oxide |
· Direct AGW: 6 hours at Fi 50% ≈ 500km driving · Depletes ozone layer · Chronic exposure can cause neuropathy, teratogenicity, miscarriage in health care workers due to inactivation of methionine synthetase |
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Sevoflurane |
· Direct AGW: 6 hours at Fi 3.5% ≈ 50km driving · ~5% metabolised |
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Propofol |
· Minimal impact on AGW, even after taking into account syringe driver, manufacture, procurement · Improperly discarded propofol is toxic to marine life · Syringes and tubing contribute to medical waste · Almost 100% metabolised; metabolites excreted in urine · Environmental effects of metabolites unknown |
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Ketamine |
· Minimal impact · Can be used as a sole agent · Minimal effects of ABC · Hence reduces need for other disposable equipment |
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Neuraxial/regional local anaesthetics |
· i.e. bupivacaine, ropivacaine, lignocaine · Minimal direct impact · Can be performed without sedation or general anaesthesia · Hence reduces need for other disposable equipment |
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