Questions to Ask an Anesthesiologist
For patients, and for the parent or relative sitting beside one, at the pre-operative visit or in the few minutes the anesthesiologist spends at the bedside on the morning of surgery. The questions follow the order that conversation usually takes: the type of anesthesia and why, what your own health changes, getting ready, who is in the room, waking up, and the bill. The morning visit is short, so mark the handful that apply to you before you get there.
The questions
Each question, and why to ask it
The plan
What type of anesthesia do you recommend for this operation, and why that one for me?
Why ask it
The choices are usually general anesthesia, a regional technique such as a spinal or nerve block, sedation, or local numbing alone. Listen for a reason that mentions your health or this particular operation, and if you hear only the name of the technique, ask what tipped the choice.
Is there another way to do it, and what would I gain or give up with each?
Why ask it
Sometimes there is a real choice and sometimes the operation leaves only one sensible route. If there are two, have them compared on the things you care about: time to wake up, nausea, pain in the first day, and how soon you go home.
If I have a spinal or a nerve block, will I be awake, and what will I see, hear or feel?
Why ask it
Many people picture lying wide awake listening to the operation, and say no on that basis. Find out whether sedation comes with it, how deep, and whether pressure or tugging is normal so it does not frighten you if you notice it.
What is the difference between the sedation you are planning and a general anesthetic?
Why ask it
Sedation covers a wide range, from relaxed and talking to remembering nothing. Ask where on that range they are aiming, whether you will breathe on your own, and what you are likely to remember, since 'twilight' means different things in different places.
Will I have a breathing tube, and is it placed after I am asleep?
Why ask it
Worth asking if the tube is the part that scares you, because the answer about timing is often the reassuring part. The follow-up is what your throat or voice may feel like the next day, and how long that tends to last.
If the first plan does not work well enough, or the operation runs long, what do you switch to?
Why ask it
A block that does not take fully, or sedation that turns out not to be enough, usually has a backup decided in advance. Hearing it beforehand means a change of plan in the room is not the first you learn of it, and it tells you what you are consenting to.
Does the surgeon have a preference, and who makes the final call on the anesthesia?
Why ask it
Surgeons sometimes say 'you'll have a general' weeks earlier, and patients take it as settled. Who decides varies by hospital and by operation, so ask how it works there and whether your own preference carries weight.
Your risks
Given my age and health, which risks are you watching most closely in my case?
Why ask it
A recital of every possible complication is less use than the two or three that apply to you. If the fear underneath is not waking up, say so, and have them put the chance in plain words for someone like you. Then find out what they do about each risk they named, and whether anything in the weeks before surgery would lower it.
I had a bad reaction to anesthesia before. What will you do differently this time?
Why ask it
Say exactly what happened: hours of vomiting, taking a long time to wake, a chipped tooth, remembering part of the operation. If it happened at another hospital, ask whether they can get that record, and bring any letter or card you were given then.
Which of my allergies matter for the anesthesia: medications, latex, tape, foods?
Why ask it
Go through every one and what it did to you, because a rash, a swollen throat and an upset stomach are three different pieces of information. Include adhesive tape and skin-cleaning solutions, which people rarely think to count, and check that the allergy band on your wrist matches what you said.
A blood relative had a serious problem with anesthesia. Does that change anything for me?
Why ask it
A few rare reactions run in families, so the details matter more than the relationship: what happened, how severe it was, and whether anyone was tested afterwards. If all you know is that something went wrong with Grandpa's operation, say that and let them decide whether to look further.
Does my sleep apnea, or heavy snoring that nobody has ever tested, change the plan?
Why ask it
Mention it even without a diagnosis, and say whether you use a CPAP machine. Two things hang on the answer: whether the machine comes with you, and whether you are watched longer afterwards or can still go home the same day.
How do my heart, lungs, diabetes or blood pressure change what you do?
Why ask it
Name each condition and how well controlled it has been lately, including the last time it sent you to a doctor in a hurry. A good answer says what they will adjust, and whether they want your cardiologist or another specialist to weigh in before the date.
Is there anything about my teeth, jaw or neck you need to know?
Why ask it
Loose teeth, crowns, bridges, a jaw that does not open wide and a stiff neck all matter to the person managing your airway. Point to the exact tooth, and ask what happens with dentures or a retainer on the day.
How do you make sure I am not aware during the operation?
Why ask it
Plenty of people carry this fear and never say it. Ask how they judge how deeply asleep you are, and whether anything about your operation or your medications makes it more of a concern. If the worry is keeping you up at night, tell them that too.
I smoke, vape, drink or use cannabis. What do you need to know, and does it change the doses?
Why ask it
Give real amounts and how recently, because the point is dosing and breathing, not a lecture. If you are worried about where the information goes, ask who can see it in your record before you answer.
I am pregnant, might be, or am breastfeeding. What changes?
Why ask it
Raise it yourself, even if a pregnancy test is routine there. For breastfeeding, ask whether you can feed as usual afterwards or need to wait, and get that in writing, since advice from different staff on the day does not always match.
At my age, or my parent's, how likely is confusion afterwards, and what can be done to lower the chance?
Why ask it
Relatives are often the ones who notice it, so this is a good one for the person coming along to ask. Find out whether the choice of anesthesia or of pain medication affects it, and what to bring from home, such as glasses and hearing aids, to help them get their bearings.
Getting ready
What time do I stop eating, and what time do I stop drinking clear liquids?
Why ask it
Get clock times for your own start time, not 'after midnight', and ask what counts as clear and whether gum or a mint matters. For a baby or child, ask separately about breast milk and formula, since those often get their own cutoffs.
Which of my regular medications do I take on the morning of surgery, and which do I skip?
Why ask it
Go down your list one by one and write 'take' or 'skip' next to each. Check that a sip of water with the morning ones is allowed, and put inhalers and eye drops on the list, since people forget those are medications.
When do I stop my blood thinner, diabetes medication or weekly injection, and who tells me when to restart?
Why ask it
Some of these need more than a day's notice, and the surgeon and the anesthesiologist can each assume the other has told you. Get a date for stopping and a named person for restarting, and do not stop anything on your own because you read it somewhere, including here.
Should I stop any vitamins, herbal products or over-the-counter painkillers beforehand?
Why ask it
Bring the actual bottles or photos of the labels, since 'a joint supplement' tells them nothing. Ask how many days ahead for each, and what you may take instead if you get a headache in the week before.
Do you need any tests from me before the day, like blood work or an EKG?
Why ask it
If tests are needed, ask where to have them done and how recent they must be, since a result from a few months ago may or may not count. 'None' is a fair answer for a healthy person having a small operation.
What should I do if I get a cold, a cough or a fever in the days before?
Why ask it
You want a phone number and a deadline for calling, because a decision made by phone two days ahead is easier on everyone than one made in the pre-op bay. For a child, ask what they count as too sick, since small children seem to have a runny nose half the year.
What do I need to remove or leave at home: contact lenses, dentures, piercings, nail polish, hearing aids?
Why ask it
The rules differ from one hospital to the next, so get their list. If you cannot hear or see without your aids or glasses, ask whether you can keep them until the last moment and have them handed back in recovery.
I am very anxious. What can you offer before I go in?
Why ask it
Say what the fear is about: needles, the mask, losing control, not waking up. The answer may be a calming medication, numbing cream for the IV, or simply being talked through each step, and you can ask for whichever would help.
How will you put my child to sleep, and can I stay with them until they are?
Why ask it
Whether a parent may come into the room varies by hospital and by the child's age. If you do go in, have them tell you what your job is, what your child will look like while drifting off, and where you wait afterwards.
In the room
Will you be the person giving my anesthesia, and will you be there the whole time?
Why ask it
The doctor you meet at the pre-op visit is not always the one assigned on the day. If it will be someone else, ask how your answers from today reach them, and repeat the two most important ones on the morning anyway.
Who else is on the anesthesia team, and who is supervising whom?
Why ask it
Depending on the country and the hospital, the team may include nurse anesthetists, assistants, residents or other trainees. Ask who is in the room from start to finish, who is nearby, and whether you can state a preference about trainees.
How often do you give anesthesia for this operation, or to children this age?
Why ask it
For a small child, a very frail adult or an unusual operation, it is reasonable to want someone who does this every week. How anesthesiologists are trained and certified depends on the country, so have them say what the credential is called there, and whether the hospital has a specialist in children's anesthesia.
What will you be monitoring while I am under?
Why ask it
You are asking for a plain tour: heart, blood pressure, oxygen, breathing, temperature. It is a calming answer to hear, and the follow-up is whether your health calls for any extra line or monitor, and whether that goes in before or after you are asleep.
What will I notice in the last few minutes before I go to sleep?
Why ask it
Knowing the sequence takes the surprise out of it: the cold room, the stickers and the cuff, the mask, the feeling in your arm as the medication goes in. If a running commentary would help you, ask them to name each step as it happens.
How will I be positioned, and how do you protect my eyes, skin and nerves during a long operation?
Why ask it
Mention a bad shoulder, a sore back, a joint that does not bend or numbness you already have, so they can pad and place you around it. This one matters more the longer the operation and the more unusual the position.
If I need blood during the operation, how is that decided, and what should you know about my wishes?
Why ask it
If you would refuse blood or certain blood products for religious or other reasons, this is the person who needs to hear it, clearly and before the day. Ask what alternatives exist there and how your wishes are recorded.
Since this is not a full hospital, what is on hand for an emergency, and where would I be transferred?
Why ask it
One for surgery centers and for dental and cosmetic offices that give sedation on site. You are listening for a specific answer: who is trained to respond, what equipment is on site, and which hospital they send people to.
Afterward
Where will I wake up, and who will be looking after me when I do?
Why ask it
Many people remember little of the first stretch, so this answer is mainly for whoever is waiting. The detail to get is whether you go to a recovery area, straight to a regular room or to intensive care, since a planned intensive care stay that the family heard about beforehand does not frighten them on the day.
How long does waking up usually take, and when can someone come and sit with me?
Why ask it
Ask for a rough range, not a promise, and what would make it longer for you. Parents should ask how soon they are called to a child in recovery, because children often wake upset and want a familiar face.
I get sick after anesthesia, or I get carsick easily. What can you do to prevent nausea?
Why ask it
Tell them before the operation, not in recovery, since prevention is planned ahead and may shape the choice of drugs. Then get three answers: what you will be given, what the nurses can add afterwards, and what to have ready for the ride home and the first night.
What is the plan for pain when I wake up, and what happens when a block or spinal wears off?
Why ask it
Have them put a rough hour on when the numbness should fade, then settle the handover: which medicine takes over, who prescribes it, and whether it is the surgeon's office or the anesthesia team you call if that is not enough. Write it down before the operation, while you can still follow it.
I want to keep opioids to a minimum. What are the other options for me?
Why ask it
Give your reason, whether it is past nausea, constipation, a history of addiction in you or your family, or simply not liking how they feel. The plan can often be built around that if they hear it early, and you can ask what the fallback is if the pain is worse than expected.
What side effects are normal in the first day or two?
Why ask it
Have them go through the common ones for your type of anesthesia, such as a sore throat, shivering, grogginess, itching or a heavy leg. Knowing what is ordinary is what lets you spot the thing that is not.
After a spinal or epidural, what should I watch for once I am home?
Why ask it
Find out how long the numbness and weakness should last, and what they want to hear about right away. Ask about headaches in particular, including what kind would be worth a call, and get the number to call.
How long until I can drive, go back to work, drink alcohol or sign anything important?
Why ask it
Many places also require an adult to take you home and stay with you for a period, and will cancel if nobody turns up. Get their rule in hours, and ask whether a taxi or ride service alone is accepted.
Which symptoms after I get home mean I should call, and what number reaches someone at night?
Why ask it
Have the list split two ways: call the hospital, or go straight to emergency care. Put the number in your phone and in your companion's before you leave, since you may be too groggy to find a discharge sheet.
Can I have a record of what I was given and how it went, for the next time I need anesthesia?
Why ask it
This matters most if anything was difficult: placing the breathing tube, severe nausea, an unusual reaction. Ask for it in writing, keep it with your medication list, and hand it to the next anesthesiologist without waiting to be asked.
The bill
Is the anesthesia billed separately from the surgeon and the facility, and who sends that bill?
Why ask it
In some systems the anesthesia arrives as its own bill from a group you have never heard of, and in others there is no bill at all. Ask how it works there and get the name of the billing group, so an unfamiliar envelope later makes sense.
Is everyone on the anesthesia team covered by my insurance?
Why ask it
Where insurance networks exist, the hospital can be in yours while the anesthesia group is not. The anesthesiologist may not know, so ask for the group's name and put the question to your insurer before the day.
Can I get a written estimate, and does the fee depend on how long the operation takes?
Why ask it
Where anesthesia is billed to the patient, the fee often depends partly on time, which is why an estimate comes as a range. Ask what the range assumes, what would push it higher, and who to call if the final bill does not match.
Making a short talk with the anesthesiologist count
Practical guidance for the conversation itself
What to have in hand for the pre-op visit
Every medication, with the dose
Write down each prescription, supplement and over-the-counter product, how much, how often, and when you last took it. The last-taken time is the part people leave off, and it is the first thing asked about blood thinners and diabetes medication.
Your past anesthetics, one line each
List each operation or procedure, the rough year, where it was done and how you felt afterwards. 'Wisdom teeth, 2019, sick for a day' is enough to steer the nausea plan.
The family story, even a vague one
Ask relatives before the visit whether anyone had trouble with anesthesia, and what actually happened. A half-remembered account still gives the anesthesiologist something to follow up, and silence gives them nothing.
Cards, machines and paperwork
Bring the card for a pacemaker or other implanted device, your CPAP machine or its settings, any allergy or difficult-airway letter, and an advance directive if you have one. Hand them over at the start so they are not found in your bag afterwards.
No pre-op visit on the calendar
Some hospitals do this by phone or questionnaire, and some only on the morning. If you have a complicated history or a past bad reaction, call and ask whether you can speak to someone from anesthesia ahead of time.
When you only meet on the morning
Open with the thing that could change the plan
You may get five minutes at the bedside. Start with the past reaction, the loose tooth, the sleep apnea or the medication you forgot to stop, and leave curiosity for last.
Admit the coffee
If you ate or drank after the cutoff, or took a tablet you were told to skip, say so plainly and say when. A delay is annoying, but the team can only plan safely around what it knows.
Ask before the calming medication
Questions and consent come first, because a sedative can blur both your judgment and your memory of the answers. If a nurse arrives with it while you still have questions, say you would like to finish talking.
Brief the person driving you home
You may still be drowsy when the going-home instructions are given, so whoever takes you home is the one who has to hear them. Hand that person this page beforehand and have them write down the pain plan, the rules for the first night and the phone number that works after hours.
Asking on behalf of a child or an older relative
Find out how your child goes to sleep
Ask whether it will be a mask or an IV, whether you can be there, and whether a comfort toy, a tablet or their own pajamas can come along. Then describe it to your child in the same plain words the team will use.
Decide what to say at home
Ask the anesthesiologist, or a child life specialist where the hospital has one, how much to explain and how far ahead for a child of that age. A short honest version usually lands better than a surprise at the door of the operating room.
Speak up about memory and confusion
For an older adult, tell the team about any memory trouble, past confusion in hospital, falls, and what a normal day looks like for them. Ask how you can help afterwards, and whether you can be with them early in recovery.
Sort out who can consent and who gets called
If the patient cannot decide alone, ask in advance what document or person the hospital needs, since the rules depend on where you live. Check that the right phone number is on the chart.
Where these conversations go wrong
Hiding something to avoid a cancellation
People leave out the cigarette, the breakfast, the chest cold or the cannabis because they fear being sent home. A postponed operation is a nuisance, and a plan built on wrong information is the thing to be afraid of.
Putting anesthesia questions to the surgeon
The surgeon can tell you what is usual for the operation, but the details of your own anesthetic are worked out by the anesthesia team. If the surgeon's office answers 'they'll go over that on the day', find out how to reach the anesthesia department sooner.
Accepting 'you'll be fine'
Reassurance is kind and tells you nothing about the plan. Follow it with 'what are you planning for me specifically?' and the real answer usually comes in a sentence or two.
Leaving the money until the bill comes
Cost questions rarely belong at the bedside, and the anesthesiologist may not know the figures. Put them to the billing office or your insurer a week or more ahead, with the name of the anesthesia group in hand.