Issn Print: 1098-7339

Publication Date: 2007/09/01


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Documentation of consent for peripheral nerve blockade: 201.

W. Whiteley; G. Foxall; R. McCahon; N. Bedforth

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Background and Aims: Recently, the “reasonable patient” has superseded the “reasonable doctor” in cases of alleged medical negligence [1]. In practical terms, anaesthetists should inform their patients of any material risk associated with an intervention that the patient may attach significance to and any discussion thereof documented [2]. The study aimed to examine consent documentation for peripheral nerve block (PNB); specifically, block failure, nerve injury, local anaesthetic (LA) toxicity, and pneumothorax (peri-clavicular plexus blocks).
Methods: A prospective, blinded audit was performed over 2 months in a teaching hospital with an active regional anaesthesia teaching program. Each patient's anaesthetic chart was examined and the following recorded; risks documented, block type, ultrasound use, patients' conscious state during block.
Results:Figure 1 summarises the documentation of risk for 100 patients. Figure 2 summarises the type of block performed. Ultrasound guidance was used in 46 patients. Blocks were performed during general anaesthesia and sedation in 43 and 19 patients respectively. The remaining patients were awake during block placement.
Conclusions: Documentation of material risk associated with PNB is limited at our institution. Patient information leaflets describing the benefits and risks of PNB may improve information disclosure, aid consent and facilitate documentation.

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