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Thursday, October 23, 2014
I need to have fairly urgent ortho surgery to fix a locked knee (entrapped cartilidge). The surgeon said that she would prefer general by an anesthesiologist; but after much effort, I can only get a CRNA-and I don`t want a nurse for this; the anesthesiologist may or may not "supervise" her and do up to 4 patients at once. My surgeon said "that`s the way it`s done, but I would want an MDA for my own case"......Anyway, this isn`t about CRNA`s (I had one for surgery in the military overseas, and it went o.k., but it was not optimal). The surgeon says that she can try the surgery with a block and the CRNA; I don`t want IV sedation (propofol) if an MDA isn`t doing the case 1:1. I`m not a nut, maybe a control freak, but the anesthesia department at the local university hospital has had a lot of problems with "less than properly supervised CRNA`s)" and I want to minimize my anesthesia. If I write on the consent "I`m not consenting to general aneshesia or sedation" is this enough? The surgeon says that she can abort the procedure if the block doesn`t take; I just don`t want a nurse to be administering general or sedation (and my surgeon says this is less than ideal).....Isthis limited consent enough? I don`t care about pain or an aborted procedure. Thanks.
In my view you are setting yourself up for problems. If you can't trust your anesthesia provider to make good decisions on your behalf without altering the normal consent document then it may be wise for you to seek your medical care at another center where you can feel more comfortable.
Gareth S Kantor, MD
Assistant Professor of Anesthesiology
School of Medicine
Case Western Reserve University