NWT ‘first in Canada’ to phase out polluting anesthetic gas

Physicians in the NWT say the territory is the first Canadian jurisdiction to stop using desflurane, an anesthetic gas described as “super polluting.”

The NWT Medical Association, which represents the territory’s physicians, made the announcement in a Tuesday press release.

The association said cheaper alternatives were now in use that do far less damage than desflurane. The group urged other provinces and territories to make the same switch.

“Having evacuated its territorial hospital along with 19 communities and multiple health centres as a result of extreme wildfires in 2023, the health community feels it is important to lead by example in reducing the drivers of climate change – known to be the biggest threat to health and health systems of the 21st century,” the association stated, adding the move “positions the Northwest Territories as a national leader in sustainable healthcare.”

Desflurane is a commonly used anesthetic gas that you might inhale at a hospital ahead of surgery.

A ton of desflurane emitted into the air is the equivalent of 3,714 tons of carbon dioxide in the atmosphere. One study, now thought by some scientists to be an underestimate, suggested the global annual emissions from anesthetic gases were roughly equivalent to a million gas-powered vehicles.

While you might think you’re the one inhaling the gas (rather than it heading straight into the air), the reality is that anesthetic gases barely change between being breathed in and breathed back out. On top of that, plenty of the product ends up being released as a medical waste gas over the course of many procedures.

Scotland became the first country in the world to fully ban desflurane in 2023, the BBC reported at the time. Some Canadian hospitals have also switched to alternatives like isoflurane and sevoflurane. While still greenhouse gases like desflurane, they do essentially the same job with much less of an environmental impact.

The NWTMA said the territory is the first entire Canadian jurisdiction to drop desflurane. At the end of December, Newfoundland and Labrador’s health authority said it had become the first province to stop purchasing the gas.

“This phase-out is not just about reducing emissions,” said association president Dr Katherine Breen. “It’s about demonstrating leadership.”

Dr Steve Kraus, a Yellowknife-based general practitioner anesthetist, said the NWT had not opted to acquire any modules of desflurane when new anesthesia machines were installed in November 2023. The gas was not used once for provision of care within the territory in 2024.

The association said other options like sevoflurane and total intravenous anesthesia “offer comparable efficacy with significantly lower environmental impact,” while sevoflurane is half the price of desflurane.

Dr Claudia Kraft, the territorial medical director, said the NWT’s health authority “supports policy measures to eliminate the use of this greenhouse gas in healthcare settings.”

“The Canadian healthcare sector is responsible for approximately five percent of national greenhouse gas emissions, among the highest per capita globally,” the physicians’ association concluded.

“By eliminating desflurane, the NTHSSA sets a precedent for integrating climate action into healthcare practices.”