GENERAL ANESTHESIA: alters your awareness of the procedure by producing sedative/amnesic effects, or sleep.
The administration of Oral/IV medication involves certain risks. These include:
Nausea and vomiting.
An allergic or unexpected reaction. If severe, allergic reactions might cause more serious respiratory (lung) or cardiovascular (heart) problems which may require treatment.
Pain, swelling, inflammation or infection of the area of the injection (IV Sedation Only).
Injury to nerves or blood vessels in the area (IV Sedation Only).
Disorientation, confusion, or prolonged drowsiness after surgery.
Cardiovascular or respiratory responses which may lead to heart attack, stroke, or death.
Fortunately, these complications and side effects are not common. Well-monitored anesthesia is generally very safe, comfortable, and well-tolerated. If you have any Questions, PLEASE ASK.
I have read and understand the above and give my consent to surgery. I further state that I HAVE NOT HAD ANY SOLIDS OR LIQUIDS BY MOUTH FOR SIX (6) HOURS PRIOR TO SURGERY. TO DO OTHERWISE MAY BE LIFE-THREATENING! I agree not to drive myself home and to have a responsible adult accompany me until I am recovered from my medications. I have given a complete and truthful medical history, including all medications, drug use, pregnancy, etc. I certify that I speak, read and write English.