INFORMED CONSENT AND PARENTAL CHOICE OF ANESTHESIA AND SEDATION FOR THE REPAIR OF SMALL LACERATIONS IN CHILDREN

This study investigated the issue of informed consent by surveying par ent preferences for local anesthesia and sedation in the repair of sma ll lacerations in their children in the emergency department (ED). Of the 45 ED patients with actual lacerations receiving a suture repair, 11 requested tetracaine adrenaline cocaine (TAC), 25 requested infiltr ated lidocaine, and 9 were not given a choice (lidocaine administered because of wound proximity to a mucous membrane site). All 45 patients preferred nonsedation over sedation. In 44 of 45 patient cases, paren ts preferred to be included in the medical decision-making for their c hildren. Of the 94 non-ED cases (interviewed in private offices) with a hypothetical chin laceration, 16 preferred TAC and 78 preferred infi ltrated lidocaine. Sixty-seven of 94 preferred nonsedation over sedati on. In 89 of 94 patient cases, parents preferred to be included in the medical decision making for their children. Favorable points of conti nuous informed consent were presented, with risks, benefits, and alter natives disclosed. From the data presented, the following conclusions were drawn: (1) parents preferred infiltrated local anesthesia more co mmonly than topical local anesthesia; (2) parents preferred nonsedatio n over sedation under the clinical circumstances described; (3) parent s overwhelmingly preferred to be included in the medical decisions aff ecting their children. Copyright (C) 1997 by W.B. Saunders Company.