The problem of shock remains to be one of the most complex phenomena in modern medicine. Despite the large number of studies carried out in this field over the past decade, the understanding of the pathogenesis of traumatic shock and the approaches to their prevention and treatment remain to be quite controversial. This greatly complicates the presentation of the issues relating to the operational and post-operative shock. Thus, first of all, we need to answer the question why the terms ‘operational shock’ and ‘post-operative shock’ in recent years are used very rarely.
Following established theory of traumatic shock, its role belongs to the pathogenesis of certain neuro-reflex changes in the body: they are represented in the leading trigger mechanism of shock and is largely determined the subsequent course of the pathological process.
Meanwhile, during and after operations in a perfect anesthetic management indicated pathogenetic factors may not have any significant value, although the development of certain functional disorders is associated with the operation, although their impact can not be ruled out entirely. Since neuro-reflex processes in the pathogenesis of acute threatening conditions during operations and after they are usually not the most crucial, surgeons and anesthetists are not considering legitimate to define these terms as ‘operational shock’ and ‘post-operative shock’. This is where a fine line can be seen, dividing clinical negligence from clinical incidents. According to medical negligence solicitors experts, the average 16-months legal processes stuck on the issue and there were several legal claims already. (more…)