Climate change, environmental degradation, and biodiversity loss are adversely affecting human health and exacerbating existing inequities, intensifying pressures on already strained health systems. Paradoxically, healthcare is a high-polluting industry, responsible for 4.6% of global greenhouse gas emissions and a similar proportion of air pollutants. Perioperative services are among the most resource-intensive healthcare services and are responsible for some unique pollutants. Opportunities exist to mitigate pollution throughout the entire continuum of perioperative care, including those that occur upstream of the operating room in the process of patient selection and optimisation, delivery of anaesthesia and surgery, and the postoperative recovery period. Within a patient-centred, holistic approach, clinicians can advocate for healthy public policies that modify the determinants of surgical illness, can engage in shared decision-making to ensure appropriate clinical decisions, and can be stewards of healthcare resources. Innovation and collaboration are required to redesign clinical care pathways and processes, optimise logistical systems, and address facility emissions. The results will extend beyond the reduction of public health damages from healthcare pollution to the provision of higher value, higher quality, patient-centred care.

中文翻译：

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提高围手术期过程中麻醉和手术的可持续性并减轻对环境的影响：叙述性回顾


气候变化、环境退化和生物多样性丧失正在对人类健康产生不利影响，加剧现有的不平等现象，加剧了本已紧张的卫生系统的压力。矛盾的是，医疗保健是一个高污染行业，占全球温室气体排放量的 4.6%，空气污染物的比例也差不多。围手术期服务是资源最密集的医疗保健服务之一，并造成一些独特的污染物。在围手术期护理的整个过程中，存在减轻污染的机会，包括在患者选择和优化、麻醉和手术实施以及术后恢复过程中发生在手术室上游的污染。在以患者为中心的整体方法中，临床医生可以倡导健康的公共政策，以改变外科疾病的决定因素，可以参与共同决策以确保适当的临床决策，并且可以成为医疗保健资源的管理者。重新设计临床护理路径和流程、优化物流系统并解决设施排放问题需要创新和协作。其结果将不仅限于减少医疗保健污染对公共卫生造成的损害，还包括提供更高价值、更高质量、以患者为中心的护理。