Cutting Costs and Carbon: The Case for Oral Paracetamol in Elective Surgery.

Aim: IV paracetamol is approximately 10 times the cost and has 68 times higher carbon emissions compared to oral paracetamol (PO) however, it has been shown to be equally as effective. This paper aims to assess potential environmental and financial savings of an oral paracetamol switch in a large day surgery unit using a simple behaviour change intervention. Methods: Charts were collected at random from the Day Surgery Unit over a four-week period. An education campaign was carried out aimed at Anaesthetic trainees and data was collected over a second four-week period. The proposed financial and carbon cost savings of the intervention were then calculated. Results: The proportion of patients who received preoperative PO paracetamol significantly increased post-intervention, from 5% (2/40) to 24.4% (11/45) (p=0.014). Projected over a one-year period, we estimate that our intervention would save the hospital €188.04 and reduce carbon emissions by 54.53 kgCO₂e from elective day cases alone, without compromising patient safety. Discussion: The education intervention led to a shift towards preoperative prescribing of oral paracetamol. The relatively simple intervention could be adapted and applied to other settings in order to yield further cost and carbon emission savings, such as the main theatre, surgical wards, and the emergency department.