OTs source of greenhouse gas N₂O emission at PGI: Study

Naina Mishra

Chandigarh, February 18

In a startling revelation, aging surgical theatres at the PGIMER have been found to be major culprits in releasing large amount of nitrous oxide (N₂O) into the atmosphere, exacerbating environmental concerns.

Used for avg 9 hrs in elective procedures

• Nitrous oxide is a greenhouse gas with a climate impact 298 times greater than carbon dioxide.
• It is used effectively for an average nine hours in elective procedures and for 20 hours in emergency surgical theatres.

Nitrous oxide, a greenhouse gas with a climate impact 298 times greater than carbon dioxide, is escaping from the outdated medical gas pipeline system at the hospital.

Over the years from 2018-2021, the nitrous oxide emissions at the hospital reached alarming levels, totalling 11,911 tonnes of carbon dioxide equivalent annually. The primary reason behind this excessive discharge of nitrous oxide is attributed to multiple sources, including leaks at the patient end, anaesthesia machine, pipeline joints and during cylinder filling.

The fact was brought forth in a study titled “Nitrous oxide splurge in tertiary health care centre and its environment impact,” conducted by the Department of Anaesthesia and Intensive Care, PGIMER.

Nitrous oxide is used effectively for an average nine hours in elective procedures and for 20 hours in emergency surgical theatres.

The surgical theatres at the premier hospital lack modern facilities like scavenging systems and operate in crowded conditions with a heavy reliance on nitrous oxide for anaesthesia. Efforts to address the issue are hindered by the archaic medical gas pipeline system, which is over 50 years old and prone to leaks.

The study asserted that operation theatres is an important contributor of N₂O pollution.

According to the study, while developed nations have phased out N₂O due to environmental concerns, its use persists in developing countries like India where hospitals struggle to upgrade infrastructure. The situation at the PGI underscores the urgent need for improved anaesthesia practices, not only for patient safety but also to mitigate the environmental impact of N₂O emissions.

The hospital is taking steps to identify and repair leakage sources, but the broader issue highlights the disparity in health infrastructure between developed and developing countries.