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Consent for pediatric anesthesia: an observational study
Author(s) -
Lagana Zoe,
Foster Andrew,
Bibbo Adriana,
Dowling Kate,
Cyna Allan M.
Publication year - 2012
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1111/j.1460-9592.2011.03770.x
Subject(s) - medicine , anesthesia , anesthesiology , sore throat , anesthetic , emergence delirium , referral , postoperative nausea and vomiting , elective surgery , odds ratio , vomiting , informed consent , incidence (geometry) , pediatrics , sevoflurane , family medicine , alternative medicine , physics , pathology , optics
Summary Background: Informed consent prior to anesthesia is an important part of the pediatric pre‐anesthetic consultation. This study aimed to observe and identify the number and nature of the anesthesia risks considered and communicated to parents/guardians and children during the pediatric informed consent process on the day of elective surgery. Methods: A convenience sample of anesthetists had their pre‐anesthesia consultations voice recorded, prior to elective surgery, during a 4‐month period at the largest tertiary referral centre for pediatric care in South Australia. A data collection form was used to note baseline demographic data, and voice recording transcripts were independently documented by two researchers and subsequently compared for accuracy regarding the number and nature of risks discussed. Results: Of the 96 voice recordings, 91 (92%) were suitable for the analysis. The five most commonly discussed risks were as follows: nausea and vomiting (36%); sore throat (35%); allergy (29%); hypoxia (25%); and emergence delirium (19%). Twenty‐seven pre‐anesthetic consultations (30%) were found to have had no discussion of anesthetic risk at all while a further 23 consultations (26%) incorporated general statements inferring that anesthesia carried risks, but with no elaboration about their nature, ramifications or incidence. The median number of risks (IQR) specifically mentioned per consultation was higher, 3 (1) vs 1 (1), P < 0.05, when the consultation was performed by a trainee rather than a consultant anesthetist and when the patient had previous anesthesia experience odds ratio 0.34, 95% CI [0.13, 0.87], P = 0.025. Conclusions: The pediatric anesthesia risk discussion is very variable. Trainees tend to discuss more specific risks than consultants and a patient’s previous experience of anesthesia was associated with a more limited discussion of anesthesia risk.