Abstract
The exclusive use of hypnotic drugs1–3 in conscious sedation (CS) produces anxiolytic and amnesic effects but does not provide complete pain relief. With informed consent (IC) the patient has an opportunity to participate in his/her health care decision.4 Complete IC includes a discussion of the following elements: the nature of the decision/procedure; reasonable alternatives to the proposed intervention; the relevant risks, benefits, and uncertainties related to each alternative. It also includes assessment of patient understanding and acceptance of the intervention. In CS, the patient is initially informed about the absence of discomfort, usually related to the procedure. In our opinion, this information is not consistent with good ethical practice because the patient is not well informed about the absence of complete analgesic effect. In order to avoid misunderstanding, we suggest that the following points should be specified in the IC: the patient could be conscious during the procedure, but will not remember anything about it; amnesia will reduce the patient’s suffering related to the event; hypnotic drugs do not reduce the neuroendocrinal pain related effect. In summary, by giving correct information to the patient there is no fear of minor compliance. Moreover, giving ambiguous information to the patient, is not ethically correct.
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