Consent from a parent and assent from a frightened 14-year-old before spinal fusion
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Maya Torres is a 14-year-old girl, 52 kg, with adolescent idiopathic scoliosis. She is otherwise healthy and is scheduled tomorrow for a posterior spinal fusion from T4 to L1, an operation of about six hours in the prone position. The plan is general anesthesia given entirely through the vein so that spinal cord monitoring works, an arterial line, two large IVs, tranexamic acid and cell salvage, with blood available. At your hospital she will spend the first night in the pediatric ICU.
Her mother, Ana, is her legal guardian. In the hallway she asked you not to mention the wake-up test "because Maya panics." Both are in the room.
Your task: explain the anesthetic to Maya and her mother and obtain consent for it.