Dr Toni B. S. Hundle MBChB FRCA FFPMRCA Consultant Anaesthetist
Dr Toni B. S. Hundle MBChB FRCA FFPMRCAConsultant Anaesthetist

Consent - Background

There are as many ways of giving an anaesthetic as there are anaesthetists. However, there are some basic principles for all general anaesthetics such as ... we get you off to sleep; we keep you asleep, safe, and warm; we waken you after the procedure and manage your pain and any side-effects such as nausea and vomiting. Finally, we make sure you have adequate pain management package on discharge.

Anaesthesia is as much an art as it is a science. Anaesthetists are not all the same and they certainly do not share all the same experiences. Each anaesthetist has different processes, medications, skills, and expertise. Patients also come in all shapes and sizes with different requirements, experiences, and expectations. Therefore, there can never be a standard consent process for each individual patient. Consent entails gathering and sharing information between the 3 key parties in the surgery, namely the patient, the surgeon, and the anaesthetist. Then an anaesthetic plan A, B, C etc. can be proposed to the patient with emphasis on the risks and benefits of each plan or technique. Sadly, all options may not be available to each patient because of confounding issues that may be surgeon or anaesthetist related.  There may even be limitations based on the patient’s comorbidities etc. Different surgeons approach the same operation in different ways and not all anaesthetists are able to perform nerve blocks for example.

 

Ultimately the final say belongs to the patient, who has been made aware of all the common risks or serious consequences associated with their decisions.

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