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Abstract
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Background and Aims Consent is an essential part of the pre-operative anaesthetic assessment. The AAGBI states that ‘information about (…) associated risks should be provided to patients’, specifically stating that ‘anaesthetists should record details (…) in the patient record’ [1]. Consent has importance in ethical, professional and legal aspects and is evidenced through documentation. At Wrightington, Wigan and Leigh NHS Foundation Trust (WWL) it had been noted that consent for regional anaesthetic risks was poorly documented. An audit was therefore undertaken.
Methods Over 11 weeks, the pre-operative anaesthetic notes of patients undergoing regional anaesthesia were reviewed. Recorded information included the anaesthetic type, grade of consenting anaesthetist and risks that were consented for. The results for neuraxial vs peripheral block were analysed separately, and the following found.
Results 89 notes were reviewed: 64 neuraxial anaesthetics & 25 peripheral nerve blocks. The highest frequency of consented risk was 80% for both temporary and permanent nerve damage associated with peripheral nerve block, followed by block failure at 60%. Disappointingly, for neuraxial blocks post dural puncture headache was most consented for at only 58%. Graphs 1 & 2 further detail the frequency of consented for risks.
Consent for risks associated with neuraxial anaesthesia
Consent for risks associated with peripheral nerve block
Conclusions Despite consent for risks being integral to the pre-anaesthetic assessment for both patient and clinician safety, it is poorly undertaken. This puts patients at risk of an outcome they weren’t made aware of and it is therefore paramount that methods of improving consent documentation in WWL are implemented.