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CTRI Number  CTRI/2023/06/053583 [Registered on: 06/06/2023] Trial Registered Prospectively
Last Modified On: 05/06/2023
Post Graduate Thesis  No 
Type of Trial  Observational 
Type of Study   Observational Prospective Study 
Study Design  Other 
Public Title of Study   Effect of surgery & anaesthesia on global warming 
Scientific Title of Study   The contribution of anaesthesia & surgery to global warming - a carbon foot printing study of operating theatres of 3 different surgical specialities - A Prospective observational study  
Trial Acronym   
Secondary IDs if Any  
Secondary ID  Identifier 
NIL  NIL 
 
Details of Principal Investigator or overall Trial Coordinator (multi-center study)  
Name  Dr S Rangalakshmi  
Designation  Professor and Head of the Department of Anaesthesiology 
Affiliation  RajaRajeswari Medical College and Hospital. 
Address  Department of Anaesthesiology,Rajarajeswari Medical college and Hospital,Mysore Road,Kambipura,Bangalore Bangalore KARNATAKA 560074 India

Bangalore
KARNATAKA
560074
India 
Phone  9901703030  
Fax    
Email  rangbharat@gmail.com  
 
Details of Contact Person
Scientific Query
 
Name  Dr S Rangalakshmi  
Designation  Professor and Head of the Department of Anaesthesiology 
Affiliation  RajaRajeswari Medical College and Hospital. 
Address  Department of Anaesthesiology,Rajarajeswari Medical college and Hospital,Mysore Road,Kambipura,Bangalore Bangalore KARNATAKA 560074 India


KARNATAKA
560074
India 
Phone  9901703030  
Fax    
Email  rangbharat@gmail.com  
 
Details of Contact Person
Public Query
 
Name  Dr Dilip Kumar M 
Designation  Post Graduate 
Affiliation  RajaRajeswari Medical College and Hospital. 
Address  Department of Anaesthesiology,Rajarajeswari Medical college and Hospital,Mysore Road,Kambipura,Bangalore Bangalore KARNATAKA 560074 India
Department of Anaesthesiology,Rajarajeswari Medical college and Hospital,Mysore Road,Kambipura,Bangalore Bangalore KARNATAKA 560074 India
Bangalore
KARNATAKA
560074
India 
Phone  9591377315  
Fax    
Email  1994dilip@gmail.com  
 
Source of Monetary or Material Support  
Department of Anaesthesiology , 2nd Floor,Rajarajeswari Medical college and Hospital, Bangalore - 560074 
 
Primary Sponsor  
Name  Department of Anaesthesiology 
Address  Department of Anaesthesiology , 2nd Floor,Rajarajeswari Medical college and Hospital, Bangalore - 560074 
Type of Sponsor  Research institution and hospital 
 
Details of Secondary Sponsor  
Name  Address 
NIL  NIL 
 
Countries of Recruitment     India  
Sites of Study  
No of Sites = 1  
Name of Principal Investigator  Name of Site  Site Address  Phone/Fax/Email 
Dr S Rangalakshmi   Rajarajeswari Medical college and Hospital  Department of Anaesthesiology , 2nd Floor,Rajarajeswari Medical college and Hospital, Bangalore - 560074
Bangalore
KARNATAKA 
9901703030

rangbharat@gmail.com 
 
Details of Ethics Committee  
No of Ethics Committees= 1  
Name of Committee  Approval Status 
Institutional ethics committee  Approved 
 
Regulatory Clearance Status from DCGI  
Status 
Not Applicable 
 
Health Condition / Problems Studied  
Health Type  Condition 
Patients  (1) ICD-10 Condition: O||Medical and Surgical,  
 
Intervention / Comparator Agent  
Type  Name  Details 
 
Inclusion Criteria  
Age From  10.00 Year(s)
Age To  80.00 Year(s)
Gender  Both 
Details  Patients Undergoing surgeries in 3 superspecialty OTs
1. OT-1- Obstetrics & Gynaecology – Obstetric/Gynaecological cases taking place under Spinal Anaesthesia and occasional general anesthesia
2. OT-2 – Surgery Laproscopy – Surgical laproscopic cases taking place usually under General Anaesthesia with occasional regional anesthesia
3. OT-3 – Urology – Urological cases taking place under Spinal / General Anaesthesia 
 
ExclusionCriteria 
Details  Not applicable 
 
Method of Generating Random Sequence    
Method of Concealment    
Blinding/Masking    
Primary Outcome  
Outcome  TimePoints 
To calculate the carbon dioxide equivalents from gas emissions , energy consumed & waste generated in 3 different specialty ORs  The above parameters will be measured on daily basis at the end of 24 hrs everyday for a period of 2 months  
 
Secondary Outcome  
Outcome  TimePoints 
To determine whether there is a difference in the above parameters with the specialty of surgery & anesthesia technique employed.   At the end of 24 hrs everyday the above parameters will be calculated for 2 months duration.  
 
Target Sample Size   Total Sample Size="300"
Sample Size from India="300" 
Final Enrollment numbers achieved (Total)= "Applicable only for Completed/Terminated trials"
Final Enrollment numbers achieved (India)="Applicable only for Completed/Terminated trials" 
Phase of Trial   N/A 
Date of First Enrollment (India)   15/06/2023 
Date of Study Completion (India) Applicable only for Completed/Terminated trials 
Date of First Enrollment (Global)  Date Missing 
Date of Study Completion (Global) Applicable only for Completed/Terminated trials 
Estimated Duration of Trial   Years="0"
Months="2"
Days="0" 
Recruitment Status of Trial (Global)   Not Applicable 
Recruitment Status of Trial (India)  Not Yet Recruiting 
Publication Details   NIL 
Individual Participant Data (IPD) Sharing Statement

Will individual participant data (IPD) be shared publicly (including data dictionaries)?  

Response - NO
Brief Summary   Climate change is a major global public health priority. The delivery of health-care services generates considerable greenhouse gas emissions. Operating theatres are a resource-intensive subsector of health care, with high energy demands, consumable load, and waste volumes. The carbon hotspots are single use plastics, inhalational volatile gases , intravenous drugs , air warmer and air conditioning. These activities are generally accepted as necessary for the provision of quality care, but their environmental impacts have not been examined in detail so far. In this study, we estimate the carbon footprint of 3 operating theatres of different surgical specialties where surgeries of different surgical specialties are conducted in our hospital. This study is the need of the era to obtain data and later adopt measures to reduce the greenhouse gas emissions from healthcare services.

The Greenhouse Gas Protocol defines three scopes of emissions for accounting and reporting. Scope 1 includes direct emissions from within the organisational boundary, scope 2 represents indirect emissions due to electricity consumption, and scope 3 includes all other indirect emissions occurring as a consequence of the ORs.

SCOPE – 1

Weekly volumes of volatile anaesthetic agents (isoflurane and sevoflurane) used in the respective OTs will be determined by the volume of agent used. As volatile anaesthetics undergo minimal in-vivo metabolism, the administered volume approximates the waste anaesthetic gas volume with the exception of sevoflurane for which a 5% correction will applied. Nitrous oxide and carbon dioxide used will be calculated by the total volume of gas used.  Emissions in CO2 equivalents (kg CO2e) will be calculated using Global Warming Potential (GWP100) values from the work of Sulbaek Andersen and colleagues, which is a measure of the contribution of a greenhouse gas to climate change over a 100-year time horizon.

SCOPE – 2

Heating, ventilation, and air conditioning (HVAC) system thermal energy requirements will be calculated according to the specific system employed. Total electricity consumed will be calculated  by the power of all the electrical appliance used in the OR(airconditioning, cautery, lights, monitors, workstations,and suction apparatus) multiplied by the  time for which the equipment has been used.This will be measured in KWH.Greenhouse gas emissions due to electricity used will be calculated using grid intensities (emissions produced per kilowatt hr of electricity used) provided by local electrical utilities.A separate electrical meter in each OR will measure the total electricity consumption in each OR.

SCOPE – 3

Waste audits will be done in which all waste generated within the study boundary will be weighed and catalogued according to waste segregation practices on daily basis. We will measure total weight of various categories of waste produced in the individual ORs. This will be done on a weekly basis for 8 weeks. Production emissions factors will be used to account for emissions involved in the manufacture of surgical consumables, based on the material composition. Waste being sent to waste management company (Maridi eco industries) and the corresponding emission factors will be obtained from their records.

We will calculate the total CO2 emission equivalents of each OR individually in order to arrive at a conclusion as to the contributors to the carbon footprint.


 
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