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[Preoperative information for paediatric patients. The anaesthesiologist's point of view]
1Département d'anesthésie-réanimation, hôpital Necker-Enfants-malades, Assistance-publique-hôpitaux-de-Paris, université René-Descartes Paris-V, 149, rue de Sèvres, 75743 Paris cedex 15, France. gilles.orliaguet@nck.ap-hop-paris.fr
Insights
Providing comprehensive pediatric anesthesia information to parents is crucial for reducing anxiety. French law emphasizes the child
Area of Science:
- Anesthesiology
- Pediatric Medicine
- Medical Law
Context:
- Preoperative medical information is mandatory before procedures, especially pediatric anesthesia.
- Information delivery prioritizes parents but considers the child's opinion per French law.
- Parental preoperative anxiety often stems from anesthesia concerns rather than the surgical procedure.
Purpose:
- To outline the essential components of preoperative information for pediatric anesthesia.
- To highlight the legal considerations regarding informed consent in pediatric cases in France.
- To underscore the impact of preoperative information on parental and child psychological preparation.
Summary:
- Preoperative information for pediatric anesthesia encompasses medico-psychological and judicial aspects, with a focus on parental understanding of potential adverse effects.
- Oral information is primary, supplemented by written documents, except in emergencies or when refused.
- The quality of information directly influences psychological preparation, though the efficacy of existing programs requires further French-specific research.
Impact:
- Effective preoperative communication can mitigate parental anxiety, fostering a better psychological environment for the child.
- Highlights the need for culturally relevant, French-specific studies on preoperative preparation programs.
- Emphasizes the legal and ethical imperative of thorough patient and parental information in pediatric anesthesia.
Abstract:
Medical information is mandatory before any medical procedure, including pediatric anesthesia. Preoperative information covers many aspects, including medico-psychologic and judicial aspects. When the patient is a child, information must be delivered to the parents in priority. However, the French law has given a particular attention to the opinion of the child. In 70% of the cases, preoperative anxiety of the parents is more related to anesthesia than to the surgical procedure itself. We have to explain the most frequent adverse effects, as well as the more severe and well known complications to the parents, even though they are very infrequent. The only cases where preoperative information is not required are: emergency cases and refusal of the patient or the parents to be informed. While information is necessarily oral, it may be completed using a written document. The quality of the preoperative information directly influences the quality of the psychological preoperative preparation of the parents, and thereafter of the child. Preoperative preparation programs have been developed, but controversial results have been observed. The great majority of the studies on preoperative programs were performed in the USA, where the demand for preoperative information is very important. It is far from sure that the results of all these studies may be extrapolated to French parents, and French studies are needed.
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