LTC Charles S. Kettles VAMC Decommissions Environmentally Unfriendly Nitrous Oxide Pipeline

Nitrous oxide, often referred to as "laughing gas" for its euphoric effects, has been a staple in the world of anesthesia for decades. However, advancements in medical technology have rendered this gas nearly obsolete in the operating room. The reasons are twofold: newer, more precise anesthesia medications are available, and there is a growing awareness of nitrous oxide's environmental impact.

Often overlooked in the past, the greenhouse gas properties of nitrous oxide are now front and center. The gas is nearly 300 times more potent than carbon dioxide and can remain in the atmosphere for more than 100 years.

Mary Jarzebowski, MD, an anesthesiologist at the LTC Charles S. Kettles VAMC and member of the hospital’s Green OR Team, says studies revealed very little of the nitrous oxide that is piped throughout a hospital is being inhaled by patients during anesthesia. The vast majority of this gas delivered through the pipeline is leaked into hospitals and released into the atmosphere, posing a health risk to hospital employees as well as its known negative impacts on the atmosphere.

Recognizing the urgent need to address this environmental concern, Dr. Jarzebowski, Innovation Specialist Melissa Yates, Lead Anesthesia Technician Carla Kocsis, and CRNAs Claire Simon and Nicole Tantipitham set out to decommission the nitrous oxide pipe and transition to a more sustainable model of anesthesia delivery.

The hospital's transformation involves a phased approach over six months, ensuring that no stone is left unturned and that there are no longer any valid uses for the nitrous oxide pipe. The process began with a comprehensive analysis of the hospital's anesthesia needs while also acquiring smaller, portable nitrous oxide tanks that do not leak the greenhouse gas into the atmosphere.

LTC Charles S. Kettles VAMC is one of the first VA hospitals to fully commit to decommissioning its nitrous oxide pipe and it is expected that many other VA hospitals will soon follow suit in the coming years.

The decommissioning of the nitrous oxide pipe is more than just an operational change; it’s a symbol of VA Ann Arbor Healthcare System’s commitment to climate sustainability. In a world facing ever-increasing environmental challenges, this small yet significant step towards reducing pollution in the atmosphere and showcases the potential for positive change.