The patient’s consent to anesthesia (anesthetic aid, support and anesthesia) is reflected in the medical form confirming the patient’s voluntary consent to the appropriate procedure. Such a form, issued to the patient, informs him of the impending type of anesthesia, the possible risk or complications, and, in addition, the consequences in case of refusal of anesthesia. The patient's consent form for performing anesthesia is mandatory to fill out in case of a planned and emergency form of this medical service.
What are the standards for anesthetic benefits
As you know, absolutely all patients, as a rule, are different. For example, some of them want to get complete information about the types of anesthesia, and, in addition, about modern drugs and so on. But others, in turn, do not even want to hear about what is included in the concept of general or regional anesthesia. In such a case, it can be assumed that a certain part of patients will remain without reliable information.
On the other hand, the information may be intentionally hidden by the anesthetist, but only if the patient does not need it. Most legal portals that deal with the patient’s informed consent to anesthesia report that in any case, patients need to talk about upcoming anesthesia options taking into account the clinical diagnosis, age and personality type of the patient. True, the question of what can be said and what should not always remain open. This answer can be found in the term “deontology”.
Thus, each patient has the right to receive information about his state of health and the recommended medical and surgical diagnostic procedures. Such information makes it possible, knowing the risks and dangers, to decide whether to undergo or refuse the proposed procedure.
What are the features of anesthesiology benefits?
Features and Protocol
We will deal with this issue in more detail.
As part of the adoption of anesthetic benefits, a confirmation of the patient is recorded that he was acquainted with all the basic facts that relate to the nature and characteristics of the medical service provided.
It, when performing an operation or any medical procedure, firstly, is required for pain relief. And besides, this is necessary to ensure continuous monitoring of the patient’s condition, including supporting his blood circulation, proper breathing and other important body functions.
The protocol of the anesthetic aid confirms this.
In addition, the allowance may include the prevention of probable complications during surgery along with the timely detection and minimization of its consequences.
What types of anesthetics are available?
Today, there are several types of anesthesia:
- Conducting general anesthesia.
- Perform regional anesthesia.
- The implementation of local anesthesia.
- Conducting controlled sedation.
It is worth noting that absolutely any type of anesthesia can pose certain risks. The overall risk of death associated with anesthesia is approximately one in ten thousand anesthetics performed. In relatively healthy people, this risk is significantly lower and amounts to one case in fifty thousand cases of anesthesia.
Despite the fact that the outcome of anesthesia is usually favorable, nevertheless, during the operation, a significant fluctuation in the activity of the cardiovascular system can occur, and, in addition, the patient’s breathing, medical errors with equipment malfunctions and so on are not excluded. In most situations, such violations can be successfully eliminated by the anesthetist. However, against the background of certain conditions, this can lead to the development of additional pathologies, which are called complications of anesthesia.
What is indicated in this form?
In such a document, the person confirms that the anesthesiologist informed him of the anesthesiological aid proposed to him. Confirmed receipt of the prescription of the anesthetist to stop the use of food and liquid in a certain period of time. The patient also confirms that he explained all the dangers that may arise in case of non-compliance with a prescription. The patient agrees not to blame the medical institution and the anesthetists for the possible consequences that may occur in case of violation of any prescription.
Among other things, in this form of anesthesiology manual, the patient claims to have informed the anesthesiologist about all the previous pathologies, surgical intervention, allergies to certain substances and other other facts that relate to treatment. Thus, patients confirm that they will not assign any responsibility to the medical institution, as well as to anesthetists for the consequences that might arise if this information is not available. The patient also claims that he was not given promises with guarantees by the anesthesiologist and other employees of a medical institution regarding any outcome of anesthesia.
The consent form for the anesthetic aid also provides information on complications. A person must indicate that they explained to him that his general state of health corresponds to a certain class according to a five-point anesthetic classification. For example, a statistical study showed that the likelihood of complications during anesthesia in patients of the second class is twice as high, in the third three times, and in the fourth and fifth in four compared with patients of the first category.
Anesthesia consent form
As part of their consent, patients claim that they were given the opportunity to discuss their condition along with the proposed manual with an anesthetist. Patients note that for all questions they received satisfying answers. In addition, it is emphasized that the patient was given enough time to make a decision. Anesthetists usually provide patients with the opportunity to listen to a second opinion for a final decision.
Thus, patients voluntarily, without external pressure, give the authority to the doctor anesthesiologist, and, in addition, the resuscitator to carry out the planned anesthesiology allowance.
On what points is consent to anesthesia given?
As a rule, consent is given on the following points:
- Consent to permission to carry out the planned allowance, as well as to the implementation of alternative methods of pain relief if the anesthetist considers this necessary.
- Consent for permission to the anesthesiologist if he considers it necessary to bring in for anesthesia under the supervision of other doctors, sisters and other staff of the medical institution and students.
- Consent to permit the anesthesiologist to publish information on anesthesia for educational and scientific purposes, accompanied by descriptive texts and special illustrations, excluding the possibility of identifying the patient.
What are the components of the anesthetic?
Colonoscopy anesthesia and drug components
Colonoscopy is a procedure for examining the large intestine, as well as the final region of the small intestine, through the use of a thin fibrooptic flexible device, which consists of a light source, and, in addition, from a camera that produces images on a television screen.
Different clinics in our country use different types of anesthetic aid for colonoscopy. It is not so rare that it is done at all without any anesthesia, however, this medical procedure is considered quite unpleasant, and, in addition, also painful. Sometimes a colonoscopy is performed under local anesthesia. In this case, the tip of the colonoscope is lubricated with a local anesthetic. It is worth noting that local anesthesia does not provide sufficient comfort for the procedure.
The most optimal and often used type of anesthesia in European countries during colonoscopy is sedation. Sedation can cause a condition like sleep, while the patient goes away anxiety and fear, and, in addition, any sensations become dulled as much as possible. To perform sedation during the colonoscopy procedure, Midazolam or Propofol are most often used. Both of these anesthetic drugs differ in their advantages and disadvantages. The advantage of "Midazolam" in the first place is that its use does not cause patients any memories about the past procedure. The disadvantage of "Midazolam" is a longer period of awakening immediately after its use. A drug called Propofol provides a fairly quick wake up after the sedation phase, at the cost of some risks of preserving memories of the past colonoscopy.
What is general anesthesia for colonoscopy?
Another anesthesia option that is used in colonoscopy is general anesthesia (that is, the use of anesthesia), which provides an absolute shutdown of the patients' consciousness. Sedation, as a rule, provides comfort in ninety-five percent of cases of its use. And anesthesia during colonoscopy guarantees 100% comfort. However, one should not forget that the anesthesia during colonoscopy is associated with a lot of risks of any complications of anesthesia compared with the use of sedation. In order to carry out anesthesia, when performing a colonoscopy, different drugs from the category of anesthetics can be used. Anesthesia on the background of colonoscopy should be carried out only in the operating room, in which there is all the necessary equipment in order to ensure complete safety of the procedure.
Thus, anesthesia during colonoscopy is not considered rational, since the risks from its administration exceed the danger associated with the colonoscopy procedure itself, and in this regard, colonoscopy to patients under sedation is considered the most optimal.
Indications for colonoscopy and possible complications
Colonoscopy is often performed with digestive bleeding, and, in addition, in case of suspicion of the development of inflammatory or malignant neoplasms of the colon. Also, another indication for colonoscopy is the unmotivated decrease in hemoglobin among elderly patients.
During colonoscopy, the probe is inserted into the colon through the anus in order to visually inspect the internal intestinal surface. Colonoscopy may include some surgical procedures, for example, removal of polyps along with taking a biopsy for examination (a small particle of a sample of colon tissue). However, colonoscopy is often performed for diagnostic purposes. The duration of this procedure is usually from fifteen to sixty minutes.
In general, the risks of complications during colonoscopy are extremely low and amount to only about 0.30%. Possible complications include perforation along with bleeding, postpolypectomy syndrome, reaction to anesthetic and infections. Of the possible complications from the use of anesthesia during colonoscopy, the development of allergic reactions to anesthetics is often encountered, and, in addition, the occurrence of a respiratory problem.
Child allowance
Anesthetic benefits are provided for children.
Its main task is to ensure calm behavior of the child, regardless of the nature and extent of the intervention; favorable mental and vegetative state; painlessness and atraumatism of a variety of dental procedures.
When choosing a method of anesthesia, you must carefully consider the behavior of the child. The doctor should strive in advance to predict the behavior and condition of the child after communicating with him, performing anesthesia, during and after treatment. If you have any doubts about the choice of anesthesia method, a final consultation requires consultation with doctors of other specialties.
Young people who are over sixteen years of age are competent to give consent to any type of treatment without obtaining separate consent from their parents or guardians. Children who are younger than sixteen years of age and demonstrate the ability to adequately assess the benefits and risks of the planned treatment can also be considered competent to give appropriate consent.
Informed consent for parental anesthesia must be obtained for any patient under the age of eighteen who is not competent to provide such consent.
The use of the drug "Daralgin"
The use of "Dalargin" as a component of anesthesiology benefits is popular.
A medication under this name is an antiulcer drug. This is a synthetic hexapeptide, which is an analogue of the substance leucine enkephalin. This agent inhibits proteolysis and achieves rapid healing of ulcers that are localized in the stomach and intestines. The drug in question can have moderate antisecretory activity and, when consumed, lowers the acidity of gastric juice. In addition, they suppress the external secretion of the pancreas, as well as its response to various stimuli.
Intramuscularly, as a rule, this medication is prescribed twice a day for 1 milliliter of the drug. As part of the intravenous administration, patients receive once from 5 to 10 milliliters of the drug, which is diluted in an isotonic sodium chloride solution.
What else involves the use of "Dalargin" as a component of anesthetic benefits?
If necessary, in order to achieve the required pharmacological effects, it is possible to increase the dosage to 2 milligrams, while daily intramuscular doses can be increased to 5 milligrams. The duration of therapy may, against this background, vary from three to four weeks. The total course dosage may vary from 30 to 50 milligrams. In the presence of severe pain, a joint administration of Dalargin with antacid drugs is possible.
Thus, anesthetic management is an integral part of any surgical treatment. But capable patients have the right to give or not to give their consent to appropriate therapy or examination. In order to obtain patient consent, it is required to provide detailed information regarding the proposed treatment. Any manipulation that is undertaken without the consent of the patient in a civil court can be considered as violence, and by medical advice as a serious professional violation, which will entail consequences.
We examined what consent to anesthesiology benefits is.