Patient Forms

This section contains two very important forms, which you must read through carefully, complete before surgery and bring with to hospital, on day of surgery.
If you have any questions pertaining to any of these forms, please feel free to contact us before the planned procedure.

GENERAL INFORMATION REGARDING YOUR ANAESTHESIA:

1. No food or liquid should be taken by mouth at least 6(six) hours prior to the operation.
2. It is illegal to drive a vehicle or operate dangerous machinery within 24 Hours after general anaesthesia. It is also advisable not to take alcohol or make important decisions during this period.
3. No one can guarantee an incident free anaesthesia.
4. Anaesthetic equipment and theatre staff are supplied by the hospital and can not be guaranteed by your anaesthesiologist.

1. Patient Information Sheet:

   This form deals with your medical history.
   This is vital information in order to administer a safe anaesthetic. If you are unsure about certain medications that you use on a daily basis, please contact us before the time, since certain drugs need to be discontinued before anaesthesia, ie blood pressure medication, anti-clotting drugs, homeopathic drugs.

   

2. Informed Consent For Anaesthesia:

   By signing this form, you agree and understand the following:

   1. A qualified anaesthesiologist will provide your peri-operative care.
   2. You have been informed about the different options suitable to your condition and planned procedure
   3. During surgery, your physical and surgical condition may change, which will require changes in management of your anaesthesia.
   4. No guarantee can be provided regarding your response to the medication and drugs to be used, especially if witholding essential medical history.
   5. Complications and side effects may occur, including:
      • Sore throat, hoarseness, injury to the teeth, lung problems
      • Nausea and vomiting
      • Injury to nerves and blood vessels
      • Adverse drug reactions
      • Awareness under anaesthesia
      • Brain damage
      • Residual weakness or numbness after regional anaesthesia
      • Failed regional anaesthesia
      • The need for transfusion of blood and/or products during the procedure