英文麻醉知情同意书THE ANAESTHESIA AGREEMENT
(To be signed by the patient himself,or the responsible officer before operation)
Name of patient: Age: years
Sex:male/female ID number(if applicable): Nationality: Name of organization:
Diagnosis: Operaion:
Anesthesia:
The ana...
THE ANAESTHESIA AGREEMENT
(To be signed by the patient himself,or the responsible officer before operation)
Name of patient: Age: years
Sex:male/female ID number(if applicable): Nationality: Name of organization:
Diagnosis: Operaion:
Anesthesia:
The anaesthetist will take responsibility of the anaesthesia.But the patient will still be under the risks of anaesthesia complications and accident.
1.Respiration/heartbeat suddenly stop induce death.
2.Postoperative Headache.or Shivering.Urinary retention.
3.Extradural haematoma spinal cord injury induce paraplegina.
4.Transverse myelitis and cauda equine syndrome.
5.Nausea/vomiting induce Respiratory depression.
6.Hemorrhagic shock.
7.Neurological complications(cognitive handicap).
8.Cardiovascular complications induce of arrhythmias and
hypertension,cardiac arrest.
9.Medicine hypersensitivity-allergic;idiosyncratic-genetic;cardiac arrest If you understand it,and agree to anaesthesia,you should sign your full name here.Also we need the agreement of your contingent chief who
should be in charg of you . Patient's signature: Commander's signature Date:
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