Properties of local anesthetics.
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Knowing its pharmacological and clinical elements is essential to a good dermatological practice. Efficiency, safety, and comfort are the main concern. There are several anesthetics, and the choice of the correct one as the best application technique provides more safety, comfort, and efficiency.
It is not known exactly when the anesthesia began. Nitrous oxide is believed to have been used since 1772 by Joseph Priestley. The use of ether became famous after a public demonstration by William Thomas Green Morton in 1846, but its use is older and several other scientists have claimed the discovery of the ether as an anesthetic. The use of local anesthetics gained ground in medical science in 1884, and cocaine was widely used as a local anesthetic, although there is evidence of its use in ancient civilizations.
We can classify dermatological anesthesia in two different groups: general anesthesia and local anesthesia. General anesthesia is associated with increased risks of morbidity and mortality than local anesthesia. For this reason, local anesthesia is widely used in dermatological practice. Moreover, local anesthesia is cheaper, with less surgical time and faster recovery. Nevertheless, there are some limitations depending on the procedure’s extension and patient discomfort and collaboration. Local anesthesia can be achieved by topical products, by infiltrative nerve blocks, and by infiltrative tumescent anesthesia [1].
Nerve impulse transmission occurs when voltage-gated sodium channels on the neuronal membrane open, allowing massive influx of sodium into peripheral nerve cells. In resting state, the intracellular electric potential is negative relative to the extracellular space thanks to the cellular membrane and by Na+/K+ ATPase. The influx of sodium causes membrane depolarization and propagation of the impulse. Local anesthetics prevent nerve impulse transmission by blocking sodium channels without causing central nervous system depression or altered mental status [2, 3].
The block generally occurs in a stepwise sequence with autonomic impulses blocked first, then sensory impulses, and finally motor impulses. Unmyelinated and smaller myelinated nerve fibers are easier to block than larger myelinated fibers. Therefore, C-type fibers are the first to be blocked in a local anesthesia. Pain is first controlled followed by heat and cold sensation. Then, B-type fibers are blocked, which are the preganglionic sympathetic fibers. Finally, A-type fibers are block. Proprioception, touch and pressure, and motor fibers are the last to suffer anesthetics effects [4].
The most used anesthetic agents have three structural components: an aromatic portion, an intermediate connecting chain, and an amine portion. The aromatic portion provides hydrophobic and lipophilic properties and facilitates the diffusion of the anesthetics through nerve cell membranes. Therefore, its efficiency is improved. However, the amine portion provides lipophobic and hydrophilic properties and can become soluble for injection. The intermediate connecting chain provides the main anesthetic properties and classifies the local anesthetics into two groups: the amino amides and the amino esters [5].
Amide anesthetics—these anesthetics all have an amide linkage (i.e., bupivacaine, ropivacaine, lidocaine, prilocaine, mepivacaine). They are metabolized by microsomal enzymes in the liver and excreted by the kidneys. Decreased liver function may lead to amide anesthetics toxic effects [2, 6].
Ester anesthetics—they have an ester linkage (i.e., procaine, chloroprocaine, tetracaine, benzocaine, cocaine). The ester anesthetics use to have a shorter duration. They are hydrolyzed by plasma pseudocholinesterases and excreted by the kidneys. Decreased levels of plasma pseudocholinesterases may lead to toxic effects. The metabolite para-aminobenzoic acid (PABA) is a major metabolic product and is associated with higher incidence of allergies [2, 6].
The main properties of anesthetics are potency, toxicity, onset of action, and duration of action (Table 1). Lipid solubility use to be directly associated with potency as the compound penetrates the nerve cells more easily. The protein type and its capacity of maintain the sodium channels receptor binding is association with duration of action. The dissociation constant (pKa) determines the proportion of the anesthetics base and its cation at a given pH and is associated with shorter onset of action and less toxicity. However, if the pH is raised too much, the anesthetic may precipitate out of solution [7].
Anesthetic | pKa | Onset (min) | Duration (min) without epinephrine | Duration (min) with epinephrine | Max dose (mg/kg) without epinephrine | Max dose (mg/kg) with epinephrine |
---|---|---|---|---|---|---|
Chloroprocaine | 9 | 5–6 | 30–60 | N/A | 11 | 14 |
Procaine | 8.9 | 5 | 30–90 | 30–180 | 10 | 14 |
Tetracaine | 8.6 | 7 | 120–240 | 240–480 | 2 | 2 |
Bupivacaine | 8.1 | 2–10 | 120–240 | 240–480 | 2.5 | 3 |
Etidocaine | 7.7 | 3–5 | 200 | 240–360 | 4.5 | 6.5 |
Lidocaine | 7.7 | <1 | 30–120 | 60–400 | 5 | 7 |
Mepivacaine | 7.6 | 3–20 | 30–120 | 60–400 | 6 | 7 |
Prilocaine | 7.7 | 5–6 | 30–120 | 60–400 | 7 | 10 |
Ropivacaine | 8.2 | 1–15 | 120–360 | Not yet defined | 3.5 | Not yet defined |
Lidocaine is labeled pregnancy category B. However, it is recommended that lidocaine and all other anesthetic agents be used warily during first trimester of pregnancy. The anesthetic agents commonly cross the placenta barrier and achieve the fetus. For use in children, the maximum recommended dosage should be adjusted to child’s weight. In infants, prilocaine is associated with major risk of methemoglobinemia [8] (Tables 2 and 3).
Anesthetics used for local infiltration.
Many additives to local anesthetics have been studied. The aim of making complex anesthetic’s solutions is to achieve better efficacy and safety during dermatologic surgery.
We can mix different local anesthetics in an attempt to take advantage of useful properties of each drug. For example, short-duration anesthetics like lidocaine can be mixed with a long-duration one like ropivacaine in an attempt to gain in durability. As well as, longer onset anesthetics can be mixed with shorter ones. However, this kind of association is not as logical as it seems, the nerve blockades obtained by mixing commercially available solutions of local anesthetics are unpredictable and may depend on a number of factors, which include not only the types of drugs but also the pH of the mixture. It is possible also to inject a rapid-onset anesthetic first to a longer-onset anesthetic, without mixing them [10].
Most local anesthetics promote vasodilatation by relaxation of vascular smooth muscle. Cocaine is the only example of local anesthetics that promotes vasoconstriction, and ropivacaine seems to be a local anesthetic that causes neither vasodilatation nor vasoconstriction. Cocaine is a norepinephrine reuptake inhibitor, thus potentiating sympathetic stimulation and causing hypertension and ventricular irritability.
Vasoconstriction at the operative site is commonly intended because it promotes less bleeding and facilitates the ease of surgery. Moreover, vasodilatation increases systemic absorption of anesthetics solution decreasing duration and efficacy of the anesthesia and increasing also systemic toxicity. Therefore, epinephrine can be useful decreasing bleeding and anesthetics systemic toxicity, and increasing their efficacy and duration [11].
Epinephrine is widely used in dermatologic surgery to promote vasoconstriction. It typically requires 5–15 min to reach full vasoconstriction effect. There are premixed solutions with epinephrine at a concentration of 1:100,000 and 1:200,000. However, effective vasoconstriction is achieved with a 1:100,000 concentration and risks of side effects are greater in 1:200,000 concentration. The maximum dose is 1 mg over approximately 8–10 h; however, this dosage should be much lower (or even absent) depending on patient age and concomitant health issues [12, 13]. Physicians using local anesthetic with epinephrine should be aware of this interaction. Epinephrine is a strong β- and α-agonist and can cause severe hypertension in patients using β-blocker medications [14]. Patients with severe cardiovascular disease may have their underlying diseases exacerbated with epinephrine use, as well as patients with narrow angle glaucoma. Patients taking monoamine oxidase inhibitors, tricyclic antidepressant, and phenothiazines are more sensitive to epinephrine. However, absolute contraindications to their use are hyperthyroidism and pheochromocytoma.
Systemic side effects of epinephrine can be self-limited or leaves to death. Therefore, it is important to avoid unintentional intravascular injection of epinephrine. Self-limited side effects include palpitations, anxiety, sweating, tremor, tachycardia, and elevated blood pressure. These signs and symptoms usually resolve within a few minutes, but the patient must be under continuous monitorization to identify a serious side effect. Serious side effects of epinephrine include cardiovascular and cerebral suffering. Arrhythmias, tachycardias, and ventricular fibrillation are between the most common severe side effects.
Epinephrine is labeled pregnancy category C. The effect of pregnancy on arterial sensitivity to vasoconstrictors is controversial. Pregnancy was demonstrated to be associated with a significant reduction in both uterine artery response and sensitivity to norepinephrine, epinephrine, and phenylephrine. However, there was no consistent pregnancy-associated effect on carotid artery response and sensitivity [15]. This reduction in artery response can be related to a fetal suffering, particularly in the first semester, and a premature labor in the third semester. Thereby, it is prudent to postpone nonurgent procedures requiring the use of epinephrine until after pregnancy.
Epinephrine found commercially available with lidocaine in premixed solutions contains acidic preservatives, such as sodium metabisulfite and citric acid [16]. As lower pH solutions use to cause more pain on injection, fresh lidocaine and epinephrine solutions are preferred than commercially lidocaine and epinephrine solutions [17].
The use of epinephrine on digits may prolong the duration of anesthesia and reduce the risk of bleeding during surgery, but it has been associated once with digital necrosis caused by vasoconstriction. Recent big studies recurrently demonstrate that evidence is insufficient to recommend use or avoidance of adrenaline in digital nerve blocks. However, there are case reports describing digital necrosis after injection of lidocaine with epinephrine. These digital necrosis cases can be as associated with vessel compression, constricting circumferential dressings, tourniquets, infection, hematoma, or patient’s vascular disease. In absence of these conditions, the use of epinephrine on digits seems to be safe. However, if a tourniquet is used during the surgery, there is no benefit of using also epinephrine to control bleeding [18, 19, 20].
Lower pH solutions use to cause more pain on injection [17]. That is why the pain of infiltrating lidocaine with epinephrine into skin is reduced by the addition of sodium bicarbonate. Adding sodium bicarbonate to anesthetic solution of lidocaine plus epinephrine in a proportion of 1–10 can raise the solution’s pH from approximately 5.0 to approximately 7.5. As epinephrine concentration declined approximately 25% per week in anesthetic solution containing sodium bicarbonate, it is recommended to use fresh solutions [21, 22].
In addition, alkalinization of local anesthetics solutions leads to a faster onset of action and a better anesthetic efficacy. However, it declines the duration of both anesthesia and vasoconstriction.
Hyaluronidase is an enzyme that depolymerizes hyaluronic acid. Despite it is famous in correcting acid hyaluronic fillers defect, it can be used in dermatologic surgery as an addition to local anesthetics by facilitating diffusion of solutions through tissue planes further away from the injection point. Although the duration of anesthesia is slightly decreased, the addition of hyaluronidase to local anesthesia offers the benefits of minimizing loss of surface contour and enhanced ease in undermining and dissection through subcutaneous tissue planes [23, 24].
The decrease of anesthesia’s duration and the major toxicity are explained due to increased absorption of the solution. That is why the tumescent technique must be avoided in hyaluronidase solution. The dosage usually recommended is one ampule to 30 ml anesthetic solution.
Local anesthetics side injection frequently causes pain and local edema. Transient bruise and motor nerve paralysis can also occur. These are common local side effects. More rarely is nerve injuries. Intraneural injection can cause nerve damage and prolonged sensory nerve paresthesia may develop.
Despite local anesthetic systemic toxicity (LAST) is relatively rare, it must be considered whenever local anesthetic is administered. Difficulties in the clearance of these drugs can also be an important cause of LAST.
Central nervous system toxicity is due to intracellular voltage-gated fast sodium channels blockage in neuronal tissue. It all begins with blockade of cerebral cortical inhibitory pathways, leading to excitation, sensory and visual disturbance, muscle twitching, and convulsions. Perioral paresthesia is a classic early manifestation of LAST. CNS depression comes later with dizziness, confusion, unconsciousness, coma, and respiratory arrest [25].
Cardiovascular toxicity can be expressed by different kinds of arrhythmias. Local anesthetics block sodium channels in cardiovascular conducting cells and reduce the rate of depolarization and propagation of action potentials. Thereby, PR, QRS, and ST intervals become larger increasing the risk of bradyarrhythmia and re-entrant tachyarrhythmias. Myocardial depression and changes in systemic vascular resistance is also described. Among the commonly used local anesthetics, bupivacaine is the most cardiotoxic one [26].
Usually, central nervous systemic toxicity signs precede cardiovascular toxicity signs whereas it is not a rule. The majority of LAST events occurs within several minutes of local anesthetics injection, but onset of symptoms can be delayed up to 60 min. Intra-arterial injection of anesthetics deflagrates almost immediately the LAST symptoms, as in intravenous injection or in systemic abortion, and there is a delay in the onset of signs [27].
Risk factors for LAST include drug pharmacological properties, administration dynamics, and patient factors. Local anesthetics should be reduced by 15% in babies less than 4 months old due to immaturity of hepatic enzymes [28]. Elderly people can have clearance of anesthetics reduced. Renal dysfunction is not related to more LAST and routine dose reduction is usually unnecessary. Hepatic dysfunction is offset by an increased volume of distribution of anesthetic agents and injections doses should be limited accordingly to the severity of hepatic dysfunction. Severe cardiac dysfunction can cause reduced hepatic and renal perfusion taking to clearance deficiency. Pregnant patients also can have increased cardiac output in second and third semester pregnancy [29].
There are maximum doses permissible for each anesthetic agent, and it is usually bigger when vasoconstrictors are associated. However, LAST may occur despite adherence to these limits. Therefore, practitioners should always use the lowest dose necessary to achieve the desired result due to the significant risk of systemic toxicity [30].
Besides respect the maximum anesthetics dosage, it is important to avoid intravascular injection. Ultrasound-guided peripheral nerve blockade reduces risk of LAST [31].
The management of LAST is mainly clinical support. Intravenous access, oxygen, and standard monitoring should be a routine for all patients with suspect of LAST. However, there are other clinical evidences that must be distinct of LAST, as vasovagal or allergic reactions [32].
Vasovagal reactions are by far the most common situation that must be distinct of LAST. Patient anxiety can result in an increase in parasympathetic tone. Dizziness, nausea, distal paresthesia, and hypotension are the main symptoms [33].
Although allergic reactions to anesthetics are commonly reported, true allergic reactions are actually rare. Local anesthetics are too small to be antigenic by themselves but are sufficiently alien to bind as haptens to tissues with antigenic properties. Up to 14 days are required to develop sensitization (antibody production). Once sensitization occurs, exposure to fractional quantities of the offending agent invokes an antigen-antibody reaction. Responses are classified into four categories depending upon the response. Type I reactions are IgE-mediated and are characterized by a massive release of histamine, serotonin, leukotrienes, and other humoral substances from mast cells resulting in a sudden onset of bronchospasm, cardiovascular depression and airway compromise, otherwise known as anaphylaxis. This is a true medical emergency and requires immediate and aggressive treatment. Type IV reactions represent the other end of the spectrum. Characteristically, they have a slower onset, associated with a non-IgE mediated release of bioamines, including histamine. The severity of the reaction depends on the quantity of the mediator released and can vary from mild contact dermatitis to anaphylactoid shock [34, 35].
Allergies have been reported for each class of local anesthetics, but cross-over sensitivity does not occur. Ester local anesthetics are metabolized to a PABA-like compound, and anaphylaxis has been reported. Amide local anesthetics sometimes contain the preservative methylparaben, which has also been reported to cause severe allergic reactions. It is important to know which class of local anesthetic caused the reaction and avoid that class in the future [2].
Taking a thorough history in these cases and reviewing all relevant medical and dental records are the best way of doing it. Allergists usually carry out skin testing whereas they are equivocal in a large percentage of cases [34].
Topical anesthetics act on the peripheral nerve endings in the dermis or mucosa, reduce the sensation of pain at the site of application, and avoid local pain caused by needling. They are useful aids during dermatologic treatment, especially in children, by mitigating discomfort and pain. Topical anesthetics also avoid tissue edema and surgical site distortions [36].
Their delivery and effectiveness can be enhanced by using free bases, by increasing the drug concentration, lowering the melting point, by using physical and chemical permeation enhancers and lipid delivery vesicles. Topical anesthetics are also able to penetrate mucosal surfaces, such as the mouth, genitals, and conjunctiva more easily than through a keratinized surface because of the absence of a stratum corneum [37].
Topical anesthetics seem to be safe, whereas systemic absorption occurs and systemic toxic events must be prevented. Extra caution is needed in damaged skin barrier, in infants, in mucosa, and in the extension of the applied corporal area [38].
The discovery of various amide and ester local anesthetics, their topical preparations and delivery systems in due course of time opened the gate of immense possible uses of topical anesthetics. The main topical anesthetics for mucous membrane and intact skin are benzocaine, dibucaine, lidocaine, prilocaine, proparacaine, and tetracaine. They exist in isolated form or in mixed different formulas.
Cryoanesthesia is the reduction of pain by applying cold agents to the skin. Various topical freezing agents are available: applying ice to the skin, the use of cooled gel or a cold glass, vapocoolant equipments, and cryogen sprays. The efficacy of cryoanesthesia is variable, and it has risk of causing scars and hyper or hypopigmentation [39].
Local anesthetic injection is often cited in literature as the most painful part of minor procedures. It is also very possible for all doctors to get better at giving local anesthesia with less pain for patients [40].
The pain of needle insertion can be reduced by verbal distraction, massage at neighborhood of the local of injection, pinching, quick and right need injection, the use of previously topic anesthetics, and accessory vibratory and cooler equipments. Small needles are related to less pain also. Additional sticks should be through an already numb area, and the injection should start on the side that the sensory innervations are coming from.
Sometimes, the injection of the anesthetic solution is more painful than the needle insertion itself due to tissue distension and solutions’ pH. To minimize tissue distension, the slowly injection of the anesthetic fluid is recommended. This is better obtained by the use of smaller needles and syringes. Subcutaneous injections promote less pain because of better tissue distension than intradermal injection. Acid solutions are usually associated with major pain. That is one reason why doctors associate sodium bicarbonate with anesthetic solutions. Intracutaneous instillation of lidocaine at body temperature is no less painful than injection at lower temperature [41].
Nerve block anesthesia also can minimize multiple anesthetics injection, besides decreasing the amount of solution need and its side effects. It is good to anesthetize large areas with little surface distortion. In general, nerve blocks cause less discomfort to the patient, especially during a mucosal approach. The correct technique involves injection of the anesthetic solution around the nerve, never into the nerve, to avoid nerve injuries. It is important to remember the presence of accompanying vein and artery to the nerve. Caution is needed to prevent intravascular injection. Intraforaminal injection is not recommended due to nerve compression. It is recommended to wait for about 5–10 min for full effectiveness of nerve blocks [4].
Field block anesthesia is a technique used mainly in cyst and skin cancer surgery. Field block anesthesia involves injecting anesthetic solution around the proposed surgical site, thereby blocking surrounding innervations. It is useful to avoid tumor transection. There are case reports of neoplasm surgical skin implantation. That is why field block anesthesia is recommended. Puncturing the cyst during surgery should also be avoided to decrease cyst recurrent [42].
Tumescent anesthesia is technique, which consists in infiltrating a large volume of dilute anesthetic and epinephrine solution to produce swelling and firmness of the target areas. It was first described by Kein and Lillis for liposuction surgery. The tumescent technique for local anesthesia has made it possible to do liposuction, dermabrasion, facelifts, carbon dioxide laser full-face resurfacing, hair transplants, and large cutaneous excisions and repairs totally by local anesthesia without intravenous sedation or narcotic analgesia. These benefits are optimizing biochemical compartments, maximizing drug concentration locally, delaying systemic drug absorption, decreasing systemic toxicity, prolonging local anesthetic effects, and benefiting from augmented local hydrostatic pressure to reduce bleeding and facilitate tissue dissection [43, 44]. Lidocaine is the most used anesthetic agent, whereas prilocaine also seems to be safe and effective [45]. There is no data examining other anesthetics for use in tumescent local anesthesia.
Global warming and climate change are rising issues during the last couple of decades. Buildings including commercial and residential ones are major contributors to energy consumption [1]. Energy consumption in buildings significantly increases on a yearly basis due to the increased human comfort needs and services [2]. Multiple factors affect the energy consumption used for cooling buildings such as wall structure, window to wall ratio, and building orientation in addition to weather conditions [3]. Energy consumed by buildings was reported to compose a relatively large proportion of the global energy consumption [4]. The building construction and the way it is operated and maintained have a significant impact on the total energy and water usage of the world resources [5].
Buildings are the primary energy consumers contributing to more than 40% of the US energy usage [6]. According to the US Department of Energy (DoE), the heating, ventilation, and air-conditioning (HVAC) systems consume approximately 17–20% of the total energy bill of any facility or building [7]. The world equipment demand for HVAC systems has increased worldwide from approximately 50 billion US dollars in 2004 to more than 90 billion US dollars in 2014 and for the United States from almost 11 billion to 19 billion US dollars over the same period [8].
Thermal characteristics of building envelopes have become of rising significance for designers and owners due to its relation to energy consumption reduction. Improper thermal insulations in buildings can lead to higher chances of surface condensation when air has relative humidity higher than 80% and when the convective and radiative heat transfer coefficients of the exterior walls are small [9].
The purpose of this chapter is to discuss benefits and design guidelines for zero energy buildings. NZEBs have tremendous potential to transform the way buildings use energy. In response to regulatory mandates, federal government agencies and many other state and local governments are beginning to move toward targets for NZEBs.
Many states in the United States are mandating many rules and regulations to reduce the buildings’ energy consumption. For example, New York and California, which house more than 20% of the United States’ population, produce less than 10% of its carbon emissions [10]. These two states are leading the way in decreasing energy use through the proliferation of net-zero energy building in addition to other strategies.
According to the US Department of Energy (DoE), a zero-energy building was defined as the building that produces enough renewable energy to meet its own annual energy consumption requirements [11]. According to the European Union Article 2, a nearly zero-energy building is a building that has a very high energy performance where low energy is required by the building which should be covered to a very significant extent from renewable sources including sources produced on-site or nearby [12].
There are several metrics that define the performance of buildings such as the net-zero site energy building, net-zero source energy buildings, net-zero energy cost building, and net-zero energy emission building.
The net-zero site energy building is defined as the building that produces as much energy as it consumes when measured at the site. The net-zero source energy building is the building that produces as much energy on an annual basis as it uses as compared to the energy content at the source. On the other hand, the net-zero energy cost building is the building that uses energy efficiency and renewable energy strategies as part of the business model. Lastly, the net-zero energy emission buildings is the building design that looks at the emissions that were produced by the energy needs of the building. Figure 1 shows various energy efficiency measures.
Various energy efficiency measures.
In the last decade, energy costs have been rising, fuels are running out, and there have been global warming issues. For example, the United Kingdom has only 2 years of gas reserve, which has been put on hold of usage, and is currently buying from other countries such as Qatar and the United States. In addition to that, there have been many other issues such as health, well-being, and pollution which could be reduced if emissions are reduced as a result of better energy consumption plan.
Power stations convert only 30–35% of the input energy into electricity. The rest is rejected as waste heat. The United Kingdom alone wastes £20 billion each year by heat rejection from power plants which if used appropriately could heat Britain.
Earth’s source of fossil fuel is vanishing at a much rapid pace during the last 200 years causing high damage rates to climate change. New reserves of fossil fuels are becoming harder to find. Those that are discovered are significantly smaller than the ones that have been found in the past. Oil reserve is expected to vanish between 2050 and 2060 and so does that for gas. Coal will last longer and is expected to last till 2100 [13].
Other aspects of increased emissions and increased rate of energy consumption are global warming and significant increase rate of ice melting and glaciers. A prominent red flag out of these aspects is that nine of the ten warmest years since 1880 have been in the last decade [14]. For global warming concern, Miami has seen a temperature rise of 3°C.
A building that is designed to be more sustainable has the potential to reduce the human impact on the environment. This effect is shown in Figure 2.
Effect of sustainable buildings on the environment, social life, and economic development.
Sustainable development is the development that meets the present needs without compromising the ability of future generations to meet their own needs [15].
There are three pillars for sustainable development:
Environmental protection
Social concerns
Economic development
The environmental protection aspect deals with climate change issues, resource depletion, land use and ecology, and waste concerns and impact of cities. The human social concerns and issues deal with justice, intragenerational equity, intergenerational equity, and health and well-being issues. On the other hand, the economic development deals with developed and developing counties, employment, modernization, and technological changes.
To solve current issues toward sustainable designs, designers should meet most of the items listed under each of the three pillars. These could be visualized as the intersection common areas shown in Figure 3.
Designers’ choice to achieve the best results that meet sustainable designs.
Spreading knowledge and engagement are ultimately the top most factors to help in reducing energy consumption, pollution and emission, and other issues such as global warming. The process starts with engagement and knowledge spreading, but it should be a closed cycle and thus needs feedback on performance. There has to be supplies that provide low and zero carbon energy and, lastly, investment. With no commitment from big industrial countries, no progress would be achieved.
There are many organizations who started net-zero marketing and application such as environmental organizations, research centers, universities and schools, and some engineering solutions which aimed to save costs and energy. In the United States, California and New York are leading the way to net-zero designs. Although they occupy more than 20% of the total population in the United States, they contribute to less than 10% of the total pollution emissions.
Following design standards is the first step in the design to achieve a net-zero energy building as it is important to define the sources and inputs that would be necessary to quantify the outputs and check what it needs to balance the net-energy consumed. The next step is to simulate the energy consumption using various energy modeling techniques and tools to optimize the following:
Building orientation
Glazing area, exposure, and shading
Heat island reduction
Lighting systems and capacities
Temperatures, humidity, and relative humidity levels
Landscaping
Natural resources
The overall system efficiency
All factors should be considered together by employing passive heating or cooling strategies, such as solar chimney and direct heat gain through south-facing glazing and/or isolated gain or sunspace, considering all possible exterior wall construction that avoids thermal bridging and increasing the R-value in all roof construction, using efficient lighting system, utilizing daylighting sensors and occupancy sensors, and lastly using energy-efficient office equipment for commercial buildings and energy-efficient utilities for residential houses and buildings.
The designer should then implement life cycle analysis, net-zero water system, and net-zero energy and optimize the design as per occupancy levels.
There are three principles to achieve a good net-zero energy building design:
Building envelope measures
Not only the building should be oriented to minimize HVAC loads, but shades and overhangs should be used to reduce the direct sunrays. Multiple options are available such as roof overhangs, shades and awning, and vegetation. To reduce the heat gain through windows, the designer should avoid glazing on the east/west façade. Other measures to reduce heat gains are to increase insulation on opaque surfaces, use glazing with low solar heat gain coefficient values, use double-skin façade, and refine the building envelope to suit location conditions.
Energy efficiency measures
The first utmost factor is selecting the right-size systems for the building. This can be achieved by following ASHRAE Standard 90.1 safety factors in the design, applying factors to reasonable baseline cases, and using simulation to model the design and predict the optimized requirements. In the simulation, part load performance should be considered which would come useful when using variable volume systems, variable speed drives, variable capacity boilers, variable capacity chiller systems, and variable capacity pumping systems as well. In addition to this, the designer should consider using high-efficiency lighting and control systems such as LED lights, high-performance ballasts, dual circuited task lighting, occupancy sensors, and daylighting dimming sensors.
The designer should shift electric loads during peak demand which would optimize the energy consumption. Some recommendations for optimizing the HVAC loads are (1) using heat recovery chillers, (2) using underfloor air distribution systems, (3) using high-efficiency chillers, (4) using passive cooling, (5) applying thermal storage using phase-change materials (PCMs), (6) using combined heating and power (CHP), and (7) using natural ventilation.
At the end of the construction phase, commissioning is a crucial step to ensure the building is performing as the intended design and is meeting its objectives. Commissioning phase verifies that the building’s energy-related systems are installed and calibrated and perform according to the owner’s project requirements, basis of design, and construction documents. The commissioning phase should cover at least the HVAC systems and controls, lighting and daylighting controls, domestic hot water system and any renewable system such as wind and solar. Building commissioning can reduce energy use, lower operating costs, reduce contractor callbacks, and improve occupant productivity. Successful implementation of the commissioning process can yield 5–10% improvements in the energy efficiency.
Renewable energy measures
Go green! Maximizing the energy sources are done through the first two measures, the building envelope which promotes using less energy and the efficient utilities and equipment measures. The renewable energy measures are more expensive than these two measures, and for that designers should start with the first two measures and optimize their design which would reduce the energy requirement needed in this step.
There are various renewable energy resources, such as solar which can be used for generating electricity, storing energy, and heating water, wind, biomass systems, and other sources.
Solar water heating systems include roof-mounted solar collectors that heat a fluid which would be used to heat water stored in a cylinder. Two collector types are usually used: the flat plate and the evacuated tube type. Flat plate collectors are usually cheaper. The solar water collectors heat the water that would be stored in a cylinder directly or indirectly by heating another fluid that would heat the water. Photovoltaic systems can be used to store energy and help in shifting the peak load.
Wind systems provide energy a very effective cost if the wind is continuous and steady and its speed above 10 mph (4.47 m/s), but it is recommended to be above 25 mph (11.2 m/s).
Biomass systems could provide heat by burning the biomass material. Some examples include forests, urban tree pruning, farmed wastes, wood chips, or pellets. However, the burners usually require more frequent cleaning than oil and gas boilers.
Geothermal systems provide good source for both cooling and heating by running the refrigerant pipes under the ground that usually provide nearly constant temperatures. These systems do not produce emissions. Such systems can provide coefficient of performance of 3 or even higher.
In this section, different case studies will be presented that implemented sustainable development and net-zero energy principles. The cases were selected based on their impact as reduced energy consumption and optimized sustainable resources used for energy and water.
The Bullitt Center in Seattle was opened on Earth Day on April 22, 2013. The building is shown in Figures 4 and 5 and is rated as the greenest commercial building in the world. It is a six-story building and has a total area of 52,000 ft2 (4800 m2). The building is energy and carbon neutral, but its cost reaches as high as $18.5 million which yields $355 per square foot (per 0.09 m2). The center’s energy efficiency is 83% better than a typical office in Seattle with many efficient and sustainable energy sources including a 242 kW photovoltaic array, ground source geothermal heat exchange system, radiant floor heating and cooling, and retractable external blinds that block heat from warming the building. For water usage aspect, the center is 80% more efficient than a typical office in Seattle with live rainwater-to-portable water system that can collect up to 56,000 gallons (211,948 L) of rainwater [16]. The building also uses gray water reclamation using compositing foam flush toilets that save up to 96% of water as compared to traditional flush toilets. The building has also green roof and wetlands.
Seattle’s net-zero energy building (Bullitt Center) [17].
Seattle\'s net-zero energy building (Bullitt Center).
La Jolla Commons II is a 13-story office at the University Town Center which is considered to be one of the largest NZEB in the United States. The building has a total area of 415,000 ft2 (38,555 m2) and was completed in April 2014 in San Diego, California. The completed building is shown in Figure 6. The building is rated as pre-certified silver as per US Green Building Council and a potential building for LEED platinum. The building has slab on-grade foundation. Other sustainability features include low-emissive coatings that reflect invisible long-wave infrared (IR) heat, reduce heat gain or loss in the building, and provide greater light transmissions. The walls were all glass as shown in Figure 6 [18]. The air was supplied through underfloor air distribution (UFAD) system at 68 F (20°C). The cooling loads were 15 tons per floor and were supplied through two 560 tons cooling towers that served chillers located in the basement of the building. To achieve the net-zero energy efficiency, the building reduced the consumption through efficient designs and sustainable practices in addition to on-site generation. Fuel cells were generated at a rate of 5.4 megawatt-hour, whereas the historical expected consumption was approximately 4.5 megawatt-hour. The fuel cell technical data are shown in Table 1. The fuel cells are shown in Figures 7 and 8. The building is fed by biogas which would reduce energy costs. The cost per square footage was higher but it came with more benefits.
La Jolla Commons [18].
Inputs | |
---|---|
Fuels | Natural gas, directed biogas |
Input fuel pressure | 15 psi, gage (6.89 kPa, gage) |
Fuel required at the rated power | 1.32 MMBtu/h of natural gas |
Outputs | |
Base load output (net AC) | 200 kW |
Electrical efficiency (LHV net AC) | >50% |
Electrical connection | 480 V at 60 Hz, three- or four-wire three-phase |
Physical | |
Weight | 19.4 tons |
Size | 26\' 5" × 8\' 7" × 6\' 9" (8 m × 2.6 m × 2 m) |
Technical highlights for the La Jolla Commons fuel cells.
Fuel cells used at the La Jolla Commons building.
Fuel cells used at the La Jolla Commons building.
It is classified as one of the greenest buildings on the planet as depicted by the US Green Building Council Prez [19]. The project consists of three one-story buildings. The project is located in Baraboo, WI, with cold and humid air conditions, with over 11,900 ft2 area (1105 m2). It has a platinum rating from the USGBC LEED-NC with net-zero energy rating. The first features of this project were the reduction in water consumption which reached up to 65% through the usage of waterless urinals, dual-flush toilets, and efficient faucets. The other features were the efficient irrigation features implemented using crushed gravels instead of blacktop or concrete paving which increased the rainwater infiltration and helped in blending the developed areas with the surrounding landscape which eliminated the need for irrigation. The utmost feature for this project was the significant reduction in energy usage which reached to 70% less than a comparable conventional building by using 39.6 kW rooftop photovoltaic arrays that produces more than 110% of the project’s annual electricity needs. A sketch for the design is shown in Figure 9, and a picture showing the installed cells on the roof is shown in Figures 10 and 11.
Aldo Leopold Legacy Center in Wisconsin [20].
Photovoltaic cells used for the Aldo Leopold Legacy Center project [20].
Photovoltaic cells used for the Aldo Leopold Legacy Center project [21].
The buildings were oriented properly to have the maximum solar radiation source. Not only ground heat pumps were used as sources for heating and cooling, but Earth tubes were used to preheat and precool ventilation air, as well. Windows were utilized and properly oriented toward the south to get the maximum daylight that can reduce heat needs and lighting. The window area was maximized to optimize these two factors as shown in Figure 12.
Window orientation used to aid heating and lighting in the Aldo Leopold Legacy Center [21].
For additional heat, EPA-approved wood stove or fireplace was used. The final couple features were the usage of displacement ventilation and demand-controlled ventilation through the usage of variable frequency drives for fans that would control the amount of cooling or heating supplied to the spaces based on actual load and not the maximum designed.
The payback period for this project is expected to be around 14 years [20].
The center is located on the island of Hawaii and is used by the Natural Energy Laboratory of Hawaii. The center is used for energy and technology research and development. The center is shown in Figure 13.
Hawaii Gateway Energy Center [20].
Natural ventilation is used through copper roof that radiates heat from the sun into a ceiling plenum as shown in Figure 14. Fresh outdoor air is pulled through the natural ventilation process into the occupied space from a vented underfloor plenum. Seawater at around 45 F (7.2°C) is used to cool the air to 72 F (22.2°C) as shown in Figure 14. As with the Leopold Legacy Center, the building is properly oriented to benefit from daylighting that aids lighting and reduces the energy needed to light the interior of the building. In summer, to prevent the negative affect of solar heat gain, shades are used on all windows. The center uses photoelectric daylight sensors to control the lights in addition to occupancy sensors. This prompted lights to be off 100% during daylight hours.
Hawaii Gateway Center radiant roof system.
The building has 20-kW photovoltaic array which produces approximately 25,000 kW-hr due to high insolation in the area. Part of this power is used to power the pumps that draw seawater to cool the air and power the lights and other auxiliary electrical equipment. The building itself consumes 20% of the energy that comparable buildings use. In 2006, adjustments were made to the pumping systems which resulted in excess energy from the photoelectric system.
This chapter reviewed various techniques and designs that help achieve a net-zero energy building. The most important techniques are optimizing HVAC designs to reduce energy consumptions and usage of renewable sources. Some of the techniques include geothermal heat pumps, underfloor air distribution, radiant floor heating and cooling, retractable external blind on windows, and proper orientation of the building which would maximize heat gains in cold weather and minimize it in summer using trackable blinds, photoelectric daylight sensor, and occupancy sensor. Renewable sources include fuel and biomass cells, biogas, photovoltaic cells, and EPA wood stove for heating. Water usage as well could be optimized by using gray water reclamation and by using rainwater-to-potable live water systems.
Net-zero energy building design starts with ethical clients and demonstrators. Designers and users need to be lean in their designs to reduce the energy consumption, be clean by using energy-efficient utilities and systems, and be green by using renewable energy sources such as biomass, wind, solar, geothermal heat sink, and rivers. Canals could be a good source for heat pumps in cold weather regions [22].
Future buildings will focus more on renewable and sustainable energy resources by implementing an efficient building envelope and utilizing energy-efficient and high-performing utilities promoting reduced energy consumption levels. Future design will benefit from various potential energy resources including solar, wind, tidal, biomass, and other resources. Future system design and selection will need to simulate the various cases, variables, and scenarios to decide on optimized building design such as exposure, orientation, window to wall ratio, shading, building envelope, etc. In addition to that, artificial intelligence (AI) will play a major role in the operation and maintenance of such buildings including smart meters, smart display boards that recommend actions to tenants to reduce energy consumption, lighting control versus shading, and air-conditioning operation. Governments, local states, and cities have to commit to get this into track. They should facilitate sources access and should force using the guidelines and codes.
NZEB | net-zero energy buildings |
HVAC | heating, ventilation, and air-conditioning |
DOE | |
USGBC | US Green Building Council |
LEED | Leadership in Energy and Environmental Design |
LEED-NC | LEED-New Construction |
EPA | |
HEPA | high-efficiency particulate air |
CFM |
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