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Latest recycling frontier: exhaled anesthetic

Hospitals could save money, cut greenhouse gas output

Rachel Stults
Tennessean - printed in the Spokesman Review
November 24, 2008

NASHVILLE, Tenn. – Hospitals and surgical centers across the country release thousands of gallons of anesthetic into the air each year, as the chemical is exhaled from a patient's body, vacuumed from the operating room and funneled out of the hospital into the atmosphere.

Now, doctors at Vanderbilt University Medical Center say they have come up with a method to reduce hospitals' carbon footprints and save millions of dollars. The hospital is the first in the country to do pilot testing of a new system that collects air containing exhaled anesthetic and condenses it so it can be recycled, doctors say.

Because more than 500,000 gallons of anesthetic are released into the atmosphere in the United States each year, doctors say the environmental and economic impact of such technology will be huge.

Vanderbilt spends $1 million a year on anesthetic. With the new technology, Vanderbilt would reduce that cost to $100,000 per year.

"We are picking up valuable stuff that's been thrown away and turning it into absolute gold," said Dr. James Berry, an anesthesiology professor at Vanderbilt. "Now, we're going to do it cheaply. We're going to do it economically, efficiently, and we're going to do it environmentally."

Anesthetic Gas Reclamation, the company that created the technology, was founded by Berry, along with Dr. Leland J. Lancaster Jr., an assistant in Vanderbilt's anesthesiology department, and Steve Morris, a biomedical engineer at the University of Mississippi Medical Center.

"There are 6,000 hospitals in the United States. There are 50,000 anesthesia machines that run every day, giving people anesthetic, and in those machines, half a million gallons of (anesthetic) goes through," Berry said. "The equivalent is 3.5 million metric tons of CO2.

"In the world, there is about a billion metric tons released. So we're less than 1 percent of the problem. But this is a fixable 1 percent. And we kind of feel good about that."

The hospital stands to receive CO2 credits from the government for not emitting anesthetic – a potent greenhouse gas – into the air. Those credits would essentially pay for the technology itself, doctors say.

The idea began 10 years ago, Berry said, but it was about a year ago that he partnered with Vanderbilt to build the technology and begin pilot testing to collect the anesthetic.

Anesthetic begins in liquid form and, in the operating room, is poured into a machine that vaporizes it for the patient. With the new technology, a series of devices trap exhaled air containing anesthetic in the operating room and funnel it to the collection device, called the Dynamic Gas Scavenging System, in the hospital's basement. There, the air is chilled to minus 100 degrees, at which point the vapors turn back into liquid form. The anesthetic-free air is then released from the hospital into the atmosphere.

"There's no patient involvement," Lancaster said. "You're getting anesthesia and everything's the same. You go to sleep, you wake up, and you don't realize that now in the basement all that stuff we've used on you, we're recollecting."

Some people have questioned whether it's sanitary to reuse anesthetic that might have been used on patients with communicable diseases and other types of illnesses, Berry said. But the process of repurifying, complete with controls and approval by the Food and Drug Administration, would ensure the chemical is restored to its original form.

"There is no way something would get through," Berry said. "And there's no way anything could live in this stuff."

The collection technology has been FDA approved, and patents are pending. Selling the recycled drug has yet to be approved by the FDA but could be a couple of years away.

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