Climate Impact of Laryngeal Masks: Climate and Other Environmental Impacts of Reusable and Single-Use Laryngeal Masks in Sweden.

BACKGROUND: The use of single-use laryngeal masks has increased in recent decades; yet, their climate and environmental impacts remain poorly understood. This study aimed to compare the climate impacts of reusable and single-use laryngeal masks. METHODS: We conducted a life cycle assessment that compared the reusable Ambu Aura40 with the single-use Ambu AuraStraight and Intersurgical Igel+ laryngeal masks. Data were obtained from the manufacturers, the ecoinvent database v3.10 and from Helsingborg Hospital, Sweden. Climate impacts were assessed using the ReCiPe2016 method, assuming 40 reuses of the Aura40. The results were expressed in carbon dioxide equivalents over a 100-year period (CO2e) and presented as medians with 95% reference intervals for one use. RESULTS: The climate impact of the Aura40 was 141 gCO2e (129-156), versus 597 gCO2e (533-686) and 1000 gCO2e (848-1210) for the AuraStraight and Igel+, respectively. Compared with the Aura40, the AuraStraight had a 323% greater climate impact (∆456 gCO2eq [390-535]), and the Igel+ had a 607% higher climate impact (∆856 gCO2eq [709-1070]). The Igel+ had a 68% greater climate impact (∆404 gCO2eq [224-608]) than the AuraStraight. Sensitivity analyses indicated that the climate impact of the Aura40 exceeded that of the AuraStraight and was similar to that of the Igel+ when a high-climate-impact electricity mix was used. CONCLUSIONS: The Aura40 reusable laryngeal mask constitutes an opportunity to reduce the climate impact of anaesthesia in a setting with a low-climate-impact electricity mix. Among single-use options, the AuraStraight had a lower climate impact than the Igel+. EDITORIAL COMMENT: Single-use or reusable anesthesia equipment, like laryngeal masks have different costs associated with their use, and leave different environmental 'footprints'. This analysis presents models for these, to estimate the environmental impact and costs of these. This type of analysis is important to try to clarify the use 'case' for different alternatives for choices for materiel used in clinical areas like anesthesia.