Department of Anesthesiology, University of Michigan, 1500 E. Medical Center Dr., Ann Arbor, MI 48109, USA.
Anesth Analg. 2011 Apr;112(4):918-23. doi: 10.1213/ANE.0b013e31820a9193. Epub 2011 Feb 2.
Informed consent is a process of sharing information that facilitates the individual patient's right to self-determination. Despite its importance in anesthesia practice, the process of informed consent is rarely audited or examined. As such, there are only limited data with respect to anesthesia consent practices, particularly within the pediatric setting. We designed this study, therefore, to examine the information that parents seek regarding their child's anesthesia, what they are told, who told them, and how much of the information they recall.
Parents of children undergoing a variety of elective surgical procedures were recruited while their child was in surgery. Parents were interviewed to determine their recall of their child's anesthetic plan, postoperative pain management, and attendant risks and benefits; and then surveyed regarding what information was sought and received, and how satisfied they were with the information.
Two hundred sixty-three parents were included. Although the majority (96.2%) recalled receiving information about how their child's anesthesia would be administered, only 51.1% recalled being given information about the risks of anesthesia and 42.4% recalled how side effects would be managed. Composite scores for parental recall of anesthesia information were generally poor (4.9 ± 2.5 of 10). Furthermore, 50% and 55.7% of parents had no recall of the risks or benefits of anesthesia, respectively, and 82.9% could not recall pain medication side effects. Recall of consent information provided by anesthesia providers was significantly better than when provided by surgical personnel (P < 0.01).
Results showed that disclosure of anesthesia information to parents was often incomplete, and their recall thereof, was poor. The finding that recall of consent information provided by anesthesia providers was better than when provided by surgical personnel may serve to further the debate regarding the appropriate vehicles for anesthesia consent.
知情同意是一个信息共享的过程，有助于实现个体患者的自决权。尽管知情同意在麻醉实践中很重要，但该过程很少被审核或检查。因此，关于麻醉同意实践的数据非常有限，特别是在儿科环境中。因此，我们设计了这项研究，旨在检查父母在孩子的麻醉过程中寻求的信息、他们被告知的内容、告知他们的人以及他们回忆起多少信息。
在孩子进行各种择期手术时，招募了孩子的父母。对父母进行访谈，以确定他们对孩子的麻醉计划、术后疼痛管理以及相关风险和收益的回忆；然后对他们寻求和接受的信息以及对信息的满意度进行调查。
共纳入 263 名父母。尽管大多数（96.2%）父母回忆说他们收到了关于如何进行孩子麻醉的信息，但只有 51.1%的父母回忆说收到了关于麻醉风险的信息，42.4%的父母回忆说如何管理副作用。父母对麻醉信息的回忆综合评分普遍较差（10 分中得分为 4.9 ± 2.5）。此外，分别有 50%和 55.7%的父母不记得麻醉的风险或益处，82.9%的父母不记得止痛药的副作用。父母回忆麻醉提供者提供的同意信息明显好于手术人员提供的信息（P < 0.01）。
结果表明，向父母披露麻醉信息往往不完整，他们对信息的回忆也很差。麻醉提供者提供的同意信息的回忆好于手术人员提供的信息，这一发现可能会进一步引发关于麻醉同意的适当载体的争论。
