Currently there’s a growing ethical and legal concern regarding the practice of informed consent (IC) for anaesthesia. This practice has not been adopted on a regular basis in all institutions, despite our general health institution recommending it. The anaesthetic practice has inherent risks, aside those from the surgery specific-ones, which makes the anaesthetic consent of great importance. Anaesthetic IC should never be neglected. The aim of this study was to evaluate the degree of implementation of specific informed consent for anaesthesia in the context of elective surgery at a tertiary hospital.

After approval by the Institutional Ethics Committee (ICE), an observational prospective study was conducted. Patients aged >60 years old, submitted to elective surgery, from may to july 2017 were included. Patients who were unable to give informed consent, and those admitted in the Intensive Care Unit after surgery were excluded. The informed consent form for anaesthesia procedures used during this study was previously created by the IEC, and is used by the anaesthetic department. Demographic data, the Charlson Comorbidity Score, and whether or not the informed consent form for anaesthesia procedures was signed, were registered pre-operatively. Post-operatively, the data was obtained from the patients’ clinical records. The patients were divided in two groups, those who had informed consent signed by the anaesthesiologist (IC) and those who had not (NIC). The Chi-square, Fischer´s exact or Mann-Whitney U tests were used for comparison.

Of a total of 230 patients, 42% have signed IC for anaesthesia while 98% have signed the informed consent for surgery. There were no significant differences between the two groups, regarding gender (p=0.547), age (p=0.863), mortality (p=0.438), previous neurologic (p=0.64) or psychiatric disease (p=0.64). The group NIC was associated with a higher incidence of dementia (p=0.028), previous stroke (p=0.021) and a higher Charlson Score (p=0.017).

It was identified a low practice of informed consent for anaesthesia procedures. There seems to be an association between a worse mental or physical condition, in some situations, and the increased absence of informed consent.

08 / Obtaining informed consent for anaesthesia in elective surgery at a tertiary-care hospital: practices and ethical-legal context