Consent and anaesthetic risk

Jenkins, Kath

doi:10.1093/med/9780198719410.003.0002

Cited by 11 publications

(12 citation statements)

References 127 publications

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“…In particular, decreased duration of surgery leads to less time under general anesthesia and its associated complications. 11 We did not find a statistical significance in the rates of optimal debulking between the NACT and PS groups. In addition, although the number of dose reductions was not statistically significant, a P value of 0.056 suggests a possible relationship that could not be determined given the sample size.…”

Section: Discussioncontrasting

confidence: 60%

Debulking Surgery and Intraperitoneal Chemotherapy Are Associated With Decreased Morbidity in Women Receiving Neoadjuvant Chemotherapy for Ovarian Cancer

Robinson

Cantillo

2014

Int J Gynecol Cancer

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The NACT subjects were more likely to complete IP chemotherapy and had decreased length of stay, intensive care unit admissions, bowel resections, and duration of surgery. Both optimal debulking and dose reductions were numerically but not statistically associated with NACT versus PS. This likely reflects a relatively high overall rate of optimal debulking and low rate of dose reductions in these subjects and would require a larger group to determine significance.

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Section: Discussioncontrasting

confidence: 60%

Debulking Surgery and Intraperitoneal Chemotherapy Are Associated With Decreased Morbidity in Women Receiving Neoadjuvant Chemotherapy for Ovarian Cancer

Robinson

Cantillo

2014

Int J Gynecol Cancer

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“…Our other five patients were medically fit to undergo GA, but opted to avoid GA. This decision making was likely to be influenced by awareness of the common adverse effects associated with GA, such as nausea, vomiting, disorientation and a slower recovery (22,23). Ultimately our findings have shown that with LA the breadth of the cohort suitable for SNS treatment is widened.…”

Section: Discussionmentioning

confidence: 87%

Is Permanent Sacral nerve Stimulation Implantation Under Local Anaesthesia Feasible and Effective?

Faily¹,

Zeiton²,

Nicholson³

et al. 2015

Ann Colorectal Res

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Background: Sacral nerve stimulation (SNS) is a minimally invasive surgical technique that plays an important role in the treatment of disorders of the bladder and bowel. Permanent SNS implantation under local anaesthesia (LA) offers many advantages. Objectives: To assess if implantation of permanent sacral nerve stimulation (SNS) under local anaesthesia (LA) is feasible and effective. Patients and Methods: Using a prospective database, nine patients who had permanent SNS implantation under LA in our unit were selected and analysed. Results: Four patients suffered from underlying cardiovascular disease and LA was deemed more appropriate to minimise perioperative risks. The decision to opt for LA in the other five patients was indicated due to patient preference. The average volume of lignocaine 1% used was 25 millilitres and operative length of time was 36 minutes, with the lead inserted into the right S3 foramen in all patients. Eight patients were discharged on the day of the procedure. Long term follow up revealed that SNS alleviated the symptoms in the majority of the patients, but the benefit gained fluctuated over time. Surgical revision was required in three of these patients, these included replacement of a lead, resiting of the implantable pulse generator, and explantation of the SNS device. Conclusions: Implantation of permanent SNS under LA is a viable surgical option, associated with several advantages that apply to both patients and service provision. Performing this surgical procedure under LA avoids the perioperative risks involved with (general anaesthesia) GA and also offers the possibility of SNS treatment for patients in whom GA is medically contraindicated, ultimately widening the breadth of the cohort suitable for SNS treatment. Other potential benefits include reduction in time and costs involved in carrying out the surgery.

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“…In their judgement in Montgomery, the Justices specifically warned against this approach but, more importantly, it cannot be regarded as good medical practice to expose all patients, irrespective of their needs or wishes, to a complex, long and potentially confusing list which many would find difficult to interpret. Others have described ways of quantifying risk in a more patient-friendly manner, and we would endorse these methods [2,3]. This does not mean that well-written patient information leaflets are not of help, of course, but they should be regarded as a background source of information informing a discussion, rather than as an end in themselves.…”

Section: A Maddockmentioning

confidence: 99%