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Information should be made available to patients, which gives details of the surgery and local and general anaesthesia for ophthalmic procedures, as well as advice on what to expect on the day of admission. The Royal College of Anaesthetists and the Royal College of Ophthalmologists have a range of booklets available on their websites to help to inform patients.46,47,48
Written instructions regarding the plan for the perioperative management of existing medications, including if and when to stop anticoagulants, should be given to the patient.
Written information for patients should be easy to read in order to optimise comprehension. It should be available in an appropriate language and format for those patients who are visually impaired.49,50 It may be necessary to provide translations of patient information booklets into languages suitable for the local population.
In each hospital providing neuroanaesthesia, a neuroanaesthetist should be appointed as the clinical lead (see glossary) to manage service delivery. Adequate time for this role should be included in the lead’s job plan.
All patients should be assessed before anaesthesia or sedation for surgery by an appropriately trained doctor, nurse or PA(A).5,6
There should be a specified and therefore identifiable group of neuroanaesthetists who cover the neuroanaesthesia service and have sufficient programmed activities to deliver the elective and emergency service.4,5
An appropriately trained and experienced anaesthetist should be present for all neurosurgical operating lists and interventional neuroradiology sessions, with sufficient consultant-programmed activities to provide adequate supervision and support to trainee anaesthetists and SAS anaesthetists.5,7
Adequate anaesthetic cover should be available to provide general anaesthesia and sedation for diagnostic radiology sessions, including computed tomography (CT) and magnetic resonance imaging (MRI) scans.
Hospitals should have well integrated arrangements that ensure anaesthetists covering long neurosurgical procedures or overrunning lists are regularly relieved by an appropriate colleague for refreshment and comfort breaks.8,9,10,11
The RCoA and Association of Anaesthetists currently do not support enhanced roles for AAs until the statutory regulation for AAs is in place. Where such role enhancement exists or is proposed, responsibility should be defined by local governance arrangements.3
