Abstract：
:Informed consent is a cornerstone and routine component of the ethical practice of modern medicine. Its full theoretical application to specific clinical situations, however, presents a number of ethical dilemmas for health care providers. Obstetric anesthesia, in particular, presents many unique challenges to the process of informed consent. In this review, the ethical background to the doctrine of informed consent within the context of "principlism" is explored and critiqued. The application of principlism to actual clinical situations, the limitations of principlism in the peculiarities of the patient-physician encounter, as well as possible alternative models of ethical discourse is discussed. The process of informed consent can be broken down into seven elements: Threshold elements or preconditions, which include 1) decision-making capacity or competency of the patient, 2) freedom or voluntariness in decision-making, including absence of over-riding legal or state interests; informational elements, including 3) adequate disclosure of material information, 4) recommendation, and 5) an understanding of the above; consent elements, which include 6) decision by the patient in favor of a plan and 7) authorization of that plan. Each of these elements is discussed in turn, and their implications, especially for the anesthesiologist and the obstetric patient, are addressed.
journal_name
J Clin Anesthjournal_title
Journal of clinical anesthesiaauthors
Hoehner PJdoi
10.1016/s0952-8180(02)00505-6subject
Has Abstractpub_date
2003-12-01 00:00:00pages
587-600issue
8eissn
0952-8180issn
1873-4529pii
S0952818002005056journal_volume
15pub_type
杂志文章,评审abstract：STUDY OBJECTIVE:To compare emergence from anesthesia and the hemodynamic and respiratory depressant effects of thiopental sodium infusion plus sufentanil or fentanyl with those of isoflurane as the primary component of a balanced technique for neuroanesthesia. DESIGN:Randomized, double-blind, prospective study. SETTI...
journal_title：Journal of clinical anesthesia
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/0952-8180(92)90158-w
更新日期：1992-09-01 00:00:00
abstract：:Oxymetazoline nasal spray is a potent alpha 1-adrenergic agonist commonly used to vasoconstrict blood vessels in the nasal mucosa. In this incident, oxymetazoline nasal spray 0.025% was administered to a 2-year-old patient during general anesthesia for nasal endoscopy. Severe hypertension with reflex bradycardia progr...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/0952-8180(95)00060-u
更新日期：1995-09-01 00:00:00
abstract：STUDY OBJECTIVE:To evaluate the profile of molecular hemostatic markers in patients receiving either spinal or balanced general anesthesia for total hip arthroplasty. DESIGN:Open, randomized, observational study. SETTING:Orthopedic unit and central laboratory of a university hospital. PATIENTS:26 consenting ASA phys...
journal_title：Journal of clinical anesthesia
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/s0952-8180(03)00082-5
更新日期：2003-09-01 00:00:00
abstract：OBJECTIVE:To evaluate changes in cardiac troponin-I levels after major vascular surgery and their association with early and late postoperative cardiac complications. DESIGN:Prospective, observational investigation. SETTING:University teaching hospital. PATIENTS:75 consecutive patients undergoing major vascular surg...
journal_title：Journal of clinical anesthesia
pub_type： 临床试验,杂志文章
doi：10.1016/j.jclinane.2005.11.005
更新日期：2006-06-01 00:00:00
abstract：STUDY OBJECTIVE:To compare the ease of cannulation, success/failure rate, and complication rate between ulnar and radial arteries. DESIGN:Randomized, controlled study. SETTING:Operating room. PATIENTS:100 ASA physical status I, II, and III patients undergoing general anesthesia and requiring arterial cannulation. I...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jclinane.2006.10.012
更新日期：2007-05-01 00:00:00
abstract：STUDY OBJECTIVE:The objective was to present a proof of concept for a simple and consistently successful ultrasonograpy (US)-guided technique to block the internal branch of the superior laryngeal nerve (iSLN). DESIGN:This was a volunteer and cadaver anatomy study. SETTING:The setting was an anesthesiology department...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2015.07.016
更新日期：2015-11-01 00:00:00
abstract：:Induction of general anesthesia in the agitated or combative mentally retarded patient is challenging. Oral ketamine facilitated the smooth and safe induction of anesthesia in an adult mentally retarded patient with a history of violent behavior toward health care providers. The oral administration of ketamine is an e...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/0952-8180(90)90065-b
更新日期：1990-03-01 00:00:00
abstract：BACKGROUND:Operative hysteroscopy is accompanied by the use of distention medium. Its absorption can lead to volume overload and hemodynamic disturbances that can lead to serious complications. We investigated the impact of the type of anesthesia on decreasing these complications with the use of noninvasive thoracic bi...
journal_title：Journal of clinical anesthesia
pub_type： 临床试验,杂志文章
doi：10.1016/j.jclinane.2016.06.023
更新日期：2017-05-01 00:00:00
abstract：:A 69-year-old male with severe coronary artery disease, ankylosing spondylitis, and severe major depression was scheduled for electroconvulsive therapy (ECT). The patient had previously failed or proved intolerant of antidepressant drug therapy. The nature and severity of the patient's diseases and complexity of poten...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/0952-8180(92)90071-8
更新日期：1992-05-01 00:00:00
abstract：:The anesthetic management of a parturient with a circulating lupus anticoagulant and an anticardiolipin antibody presenting to the obstetric suite taking heparin and aspirin is discussed. Issues concerning placement of a regional anesthetic with recent aspirin ingestion and heparin therapy are discussed. Documentation...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/0952-8180(95)00175-1
更新日期：1996-02-01 00:00:00
abstract：STUDY OBJECTIVE:To assess bispectral index (BIS) monitoring on decision making during cardiac surgery with cardiopulmonary bypass (CPB) by measuring the number of preset standardized comments with and without knowing the BIS value and by classifying the interventions following the BIS data. DESIGN:Prospective, randomi...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jclinane.2004.12.018
更新日期：2005-11-01 00:00:00
abstract：STUDY OBJECTIVE:To analyze the effects of epidural analgesia for labor when dystocia occurs. DESIGN:Retrospective cohort study. SETTING:Academic health center. PATIENTS:641 low risk, nulliparous women in spontaneous labor. INTERVENTIONS:406 (63%) women received epidurals analgesia and 253 (37%) did not. Sixty women...
journal_title：Journal of clinical anesthesia
pub_type： 临床试验,杂志文章
doi：10.1016/s0952-8180(97)00222-5
更新日期：1998-02-01 00:00:00
abstract：:Visualization of thromboembolic material in the pulmonary artery is often difficult on transesophageal echocardiography, especially in the left pulmonary artery, because of the position of the left main bronchus. We present a case in which thromboembolic material within the midleft pulmonary artery was incidentally di...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2007.06.026
更新日期：2008-03-01 00:00:00
abstract：:The case of a patient with hereditary angioedema (HAE), a rare, life-threatening disorder caused by reduced activity of the C1 esterase inhibitor, and requiring off-pump coronary artery bypass graft (OP-CABG) surgery, is presented. Perioperative management of patients with HAE who undergo complex cardiac surgical proc...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2009.04.007
更新日期：2010-06-01 00:00:00
abstract：STUDY OBJECTIVES:To determine whether the first-attempt tracheal intubation incidence using the GlideScope videolaryngoscope is higher in patients with predicted increased risk of difficult laryngoscopy, and to assess the ability of other a priori defined standard risk factors to predict first-attempt intubation succes...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2011.03.006
更新日期：2011-12-01 00:00:00
abstract：STUDY OBJECTIVE:To determine if acquired long QT syndrome following right or left, radical or modified, neck dissections result in malignant arrhythmias or deaths. DESIGN:Prospective study. SETTING:Inpatient head and neck service of the Massachusetts Eye and Ear Infirmary. PATIENTS:69 patients who underwent extensiv...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/0952-8180(94)00015-v
更新日期：1995-02-01 00:00:00
abstract：:Hereditary angioedema with normal C1-esterase inhibitor (HAE-nC1INH) perioperative is a rare condition which could have potential disastrous ramifications for the anesthesiologist in the perioperative period. However, there is limited evidence and/or guidelines on the optimal way to manage these patients. We present t...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2016.08.042
更新日期：2016-12-01 00:00:00
abstract：STUDY OBJECTIVE:To compare 4 different anesthesia induction protocols, in a simulated model of rapid-sequence induction, in controlled hypertensive patients. DESIGN:Prospective, randomized, double-blind, clinical investigation. SETTING:Large metropolitan university hospital. PATIENTS:120 ASA II-III adult hypertensiv...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jclinane.2005.06.006
更新日期：2006-02-01 00:00:00
abstract：:Although digoxin remains one of the most widely prescribed drugs in the United States, potential pharmacodynamic and pharmacokinetic interactions between this compound and other drugs, diseases, and events commonly encountered in the perioperative period remain largely unappreciated. Furthermore, the therapeutic benef...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章,评审
doi：10.1016/0952-8180(92)90170-6
更新日期：1992-09-01 00:00:00
abstract：STUDY OBJECTIVE:To examine the risk of perioperative stroke on in-hospital morbidity and mortality in staged coronary artery bypass grafting (CABG) and carotid endarterectomy (CEA) procedures. DESIGN:The National Inpatient Sample (NIS) database was used to extract data on all patients who underwent staged CABG CEA pro...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2017.03.024
更新日期：2017-06-01 00:00:00
abstract：:A case of fulminant hepatic failure two days following an uneventful operation during isoflurane anesthesia is presented. Investigations included elevated bilirubin and serum transaminases in the absence of any other cause of hepatic dysfunction. The patient died on the fourth postoperative day. Subsequent postmortem ...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2011.12.004
更新日期：2012-09-01 00:00:00
abstract：STUDY OBJECTIVE:To evaluate the cardiovascular changes following induction of anesthesia, laryngoscopy, and intubation in patients receiving a bolus dose of either eltanolone or propofol. DESIGN:Randomized, controlled, blind, prospective clinical study. SETTING:General operating theaters of a university hospital. PA...
journal_title：Journal of clinical anesthesia
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/0952-8180(94)00026-z
更新日期：1995-03-01 00:00:00
abstract：STUDY OBJECTIVE:Outpatient continuous interscalene brachial plexus blocks containing bupivacaine or ropivacaine are commonly used to control pain after shoulder surgery. Interscalene blocks cause hemidiaphragmatic paresis. Because ropivacaine preferentially blocks sensory fibers, it may cause less blockade of the phren...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jclinane.2015.03.006
更新日期：2015-12-01 00:00:00
abstract：STUDY OBJECTIVE:To determine whether the previously published relationship between anesthetic technique and rate of surgical site infections (SSIs) was influenced by institution specific effects. DESIGN:Retrospective Review of Quality Assurance and Hospital Epidemiology databases. SETTING:Metropolitan medical center....
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2014.04.015
更新日期：2014-12-01 00:00:00
abstract：STUDY OBJECTIVE:To determine the value of clinical history and preoperative coagulation tests. DESIGN:Prospective, multicenter clinical investigation. SETTING:Twenty-four centers over a one-year period. PATIENTS:1,706 children scheduled for tonsillectomy. In 1, 479 out of 1,706 children, studied age was ranged from ...
journal_title：Journal of clinical anesthesia
pub_type： 临床试验,杂志文章,多中心研究
doi：10.1016/s0952-8180(00)00164-1
更新日期：2000-06-01 00:00:00
abstract：:Presented here is a case of unilateral pulmonary edema following acute subglottic edema after removal of an endotracheal tube. A 3-year-old boy, diagnosed as having nondiphtheric croup and pectus excavatum deformity, was scheduled for repair of a cleft lip. No complication occurred during the operation. After removal ...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/0952-8180(90)90049-9
更新日期：1990-01-01 00:00:00
abstract：STUDY OBJECTIVES:To evaluate changes in cerebral tissue oxygen index (TOI) values under the beach chair position before and during general anesthesia in surgical patients with or without cardiovascular risk factors. DESIGN:Prospective study. SETTING:Operating room in the university hospital. PATIENTS:Ninety-one pati...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2015.06.007
更新日期：2015-09-01 00:00:00
abstract：:Substance abuse is the most serious occupational safety issue associated with the practice of anesthesiology, with an incidence as high as 1% per year of training. The Cleveland Clinic's Anesthesiology Institute approached the process from the perspective of active prevention, including specific mandatory education pr...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2008.12.030
更新日期：2010-03-01 00:00:00
abstract：:A rare case of postoperative cardiac arrest in an otherwise healthy, 49-year-old female patient who had a laparoscopic hysterectomy, is presented. The cause of cardiac arrest was due to massive pulmonary embolism, which was detected by transesophageal echocardiography. Laparoscopic surgery is regarded as a less invasi...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2003.02.007
更新日期：2003-11-01 00:00:00
abstract：:The most frequent and acute complications of subclavian vein catheterization are arterial puncture to the subclavian artery and pneumothorax. We report an arterial puncture directly to the pulmonary artery in infant during subclavian vein catheterization. ...
journal_title：Journal of clinical anesthesia
pub_type： 杂志文章
doi：10.1016/j.jclinane.2007.10.012
更新日期：2008-05-01 00:00:00
