Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Patients must receive information in a manner that promotes understanding so they can make informed decisions about anesthesia and other medical interventions. Unfortunately, history is replete with examples of the negative consequences of inadequate disclosure of information and lack of patient understanding. While obtaining consent for anesthesia poses unique challenges, the ability of the anesthesiologist to engage the patient in meaningful discussion is critical as a means to ensure that the patient is truly informed. This narrative review aims to: 1) discuss the process of informed consent as it applies to anesthesia practice; 2) describe the salient issues related to patient capacity, disclosure, understanding, decision-making, and documentation of the informed consent process; and 3) discuss current strategies to improve the presentation and understanding of consent information. ⋯ Despite the unique challenges of obtaining consent for anesthesia on the day of surgery, attention to the manner in which information for anesthesia care is provided and adoption of simple strategies to enhance understanding can go a long way to ensure that decision-makers are appropriately informed.
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Hyperbaric 2% prilocaine (HP) is increasingly used for spinal anesthesia in day-case surgery. The aim of this prospective double-blind study was to determine the effective dose (ED)50 and the ED90 of HP for patients undergoing knee arthroscopy. ⋯ This study determined the ED50 of HP is 28.9 mg and suggests that a 40-mg dose of HP is adequate to provide successful spinal anesthesia for outpatient knee arthroscopy.