8 things to tell your anesthesiologist before surgery

There’s no such thing as a one-size-fits-all medical procedure, and that certainly applies to anesthesia.

“Everybody's physiology is different and that affects their experience with anesthesia,” said Cape Cod Healthcare anesthesiologist Kevin Vilsaint, MD, MPH.

“Patients should be very forthcoming with their anesthesiologist about their health information so that we can fine-tune their anesthesiology plan. We’re not here to judge them. We’re just here to try to make the best decisions for them, so they can do well with their surgery."

Dr. Vilsaint advises that you should tell your physician anesthesiologist if you:

Have chronic health issues – “That's definitely the biggest issue. We need to know about your heart problem, lung problem, liver or kidney problem, because they affect how your body is going to react to anesthesia and how well it's going to eliminate it from the body,” he said. “We want to be able to make the best-informed decision about your anesthesia plan.”

Take any medications or supplements – Some medications affect how anesthesia works. “We could have issues with your blood pressure, for example, or sugar control is going to be an issue if you're a diabetic,” he said. “These interactions could affect the operation itself, along with how well you're going to recover from anesthesia and how well you'll do after the surgery.

“Similarly, supplements can potentially interfere with other medications that you're taking or may mask conditions that we don't know about. Some supplements can affect bleeding and have other properties that could interfere with your surgery and anesthesia recovery.”

Smoke cigarettes – “Cigarette smoking irritates your lungs and may increase your secretions, so you may cough a lot after anesthesia,” he said. “Somebody who has a severe smoking habit could be coming in with oxygen levels that are low, and we need to monitor that.”

Use marijuana – Marijuana smoking has the same risk factors as tobacco smoking. Since it’s a sedative, it also can affect your reaction to anesthesia. “You may require more, you may require less, so we need to know about it,” said Dr. Vilsaint.

Drink alcohol – The use of alcohol affects how you’ll interact with the anesthesia and the quantity needed. “Whether it’s a beer a day or six beers a day, we’re not here to judge you,” he said. “That information allows us to determine how you will react.”

Snore – This might be a surprising item on the list, but snoring is a potential risk factor for sleep apnea. “If the patient has sleep apnea, we try to avoid or minimize opioids, because they have a harder time basically waking up from the anesthesia. They also have an increased risk for events where they stop breathing during the first 24 hours after anesthesia, so we use different modalities for a patient with sleep apnea,” Dr. Vilsaint said.

Have had heat stroke or suffered a stroke – Having these in your history means you’re at increased risk of having a severe reaction to anesthesia called malignant hyperthermia. “If this in your overall family history, we should know about it,” Dr. Vilsaint said.

Have had a reaction to anesthesia – “This is one of the big things,” he said. “If you’ve had an allergic reaction or any reaction to anesthesia, we can change our anesthetic plan to prevent that from happening again.”

Learn more about preparing for surgery.