Most people research their surgeon for weeks and never ask who will keep them alive and comfortable during the operation. Is a specialist anaesthetist present throughout? What monitoring is used? What happens if there is a problem in a small clinic?
Modern anaesthesia is very safe for healthy people, and serious events are rare. That safety depends on trained people, proper equipment, honest information from you and a facility prepared for the uncommon emergency. These are things you can ask about before you book.
Key points
- A specialist anaesthetist should assess you before surgery and stay with you throughout a general anaesthetic or deep sedation.
- Sedation is not automatically safer than general anaesthesia. Deep sedation without an anaesthetist and full monitoring is a known source of harm.
- Tell the anaesthetist everything: medicines, supplements, recreational drugs, sleep apnoea, reflux, loose teeth and past reactions.
- Weight loss injections such as semaglutide slow stomach emptying and must be declared.
- Standard fasting is typically 6 hours for food and 2 hours for clear fluids, unless your team instructs otherwise.
Types of anaesthesia you may be offered
The right choice depends on the procedure, its length and your health. The anaesthetist should explain why a type is suggested and what the alternatives are.
- Local anaesthesia: Numbs a small area while you stay awake. Used for dental work, hair transplantation and minor skin procedures. Dose limits apply, particularly over long sessions.
- Sedation: Medicines through a vein to make you relaxed or sleepy. Ranges from light to deep. Deeper levels affect breathing and need the same monitoring and skills as general anaesthesia.
- Regional anaesthesia: A spinal, epidural or nerve block numbs a region such as the lower body or an arm. Common in orthopaedic surgery, often with light sedation.
- General anaesthesia: Controlled unconsciousness with airway support. Standard for most major cosmetic, bariatric and abdominal surgery.
Who gives the anaesthetic
Ask for the role and qualification of the person responsible. In Türkiye, as in most of Europe, this is a doctor specialised in anaesthesiology and reanimation, supported by trained anaesthesia technicians or nurses. The specialist should see you before surgery, be present at induction and emergence, and remain immediately available for the whole case.
Ask whether the anaesthetist looks after one patient at a time. Ask who is in the building overnight and whether an anaesthetist can be called if you need to return to theatre. For sedation in a clinic, ask exactly who gives the drugs and who watches your breathing. The operator should not be doing both.
The pre-anaesthetic assessment
Expect questions about your heart, lungs, exercise tolerance, previous anaesthetics, family history of anaesthetic reactions, allergies, medicines and habits. The anaesthetist will look at your mouth opening, neck movement and teeth to anticipate airway difficulty, and review blood tests and any ECG. People with significant conditions may need extra tests or a specialist's letter.
Ideally this happens at least the day before surgery, with remote review of your records before you fly. An assessment minutes before theatre leaves no room to optimise anything, and puts pressure on everyone to continue regardless.
What to disclose, without exception
Anaesthetic drugs interact with many substances, and hidden information is a real hazard. Nothing on this list will shock an anaesthetist, and none of it is shared beyond the clinical team.
- Snoring, witnessed pauses in breathing or diagnosed sleep apnoea, and whether you use a CPAP machine
- Acid reflux, hiatus hernia or previous stomach surgery
- Weight loss or diabetes injections of the GLP-1 type, such as semaglutide, liraglutide or tirzepatide
- Blood thinners, antidepressants, stimulant medicines and herbal supplements
- Alcohol intake, cannabis, cocaine and other recreational drugs
- Nicotine in any form
- Severe nausea, awareness, slow waking or high fever after a past anaesthetic, in you or a blood relative
- Loose teeth, crowns, veneers, braces or piercings in the mouth
Monitoring and equipment
International standards, such as those promoted by the World Federation of Societies of Anaesthesiologists and the World Health Organization, describe minimum monitoring: continuous pulse oximetry, ECG, regular blood pressure measurement, and capnography, which measures exhaled carbon dioxide, for general anaesthesia and for deeper sedation. Temperature monitoring is advised for longer cases.
The room should have oxygen, suction, airway equipment for difficult situations, a defibrillator and emergency drugs. Facilities using triggering anaesthetic gases should stock dantrolene for malignant hyperthermia, a rare inherited reaction. Any clinic using large doses of local anaesthetic should hold lipid emulsion for local anaesthetic toxicity. After surgery you should wake in a staffed recovery area with one to one nursing until you are stable.
Fasting, medicines and the morning of surgery
Typical adult guidance is no solid food for 6 hours and clear fluids, such as water or black tea without milk, until 2 hours before anaesthesia. Your team may give different timings, and theirs apply. People taking GLP-1 injections may be given extended or special instructions because food can remain in the stomach much longer than expected.
Ask which regular medicines to take on the morning with a sip of water. Blood pressure, heart, asthma, thyroid and anti-seizure medicines are usually continued, while some diabetes and blood thinning medicines are adjusted. Do not decide this alone. Chewing gum and sweets count as intake in some hospitals, so ask.
Common side effects and rare risks
Sore throat, nausea, shivering, drowsiness and a bruise at the cannula site are common and short lived. Tell the anaesthetist if you have had bad nausea before or get travel sick, since preventive medicines work well. Dental damage, corneal abrasion and nerve pressure injuries are uncommon. Awareness under general anaesthesia, severe allergic reactions, aspiration of stomach contents and serious heart or lung events are rare, and rarer still in healthy people having planned surgery.
Risk rises with obesity, sleep apnoea, heart and lung disease, long operations and emergency settings. This is why candid disclosure, and sometimes the advice to lose weight or stop smoking first, is part of safe care and not an obstacle to it.
After the anaesthetic
Do not drive, sign important documents, drink alcohol or care for children alone for 24 hours after general anaesthesia or sedation. Arrange an adult to stay with you the first night outside hospital. People with sleep apnoea should bring their CPAP machine and use it, as opioid painkillers and residual anaesthetic can worsen breathing pauses during sleep.
When to get medical help
Call for urgent help after an anaesthetic if you have difficulty breathing, blue lips, chest pain, a swollen face or throat, a widespread rash, confusion or extreme drowsiness, repeated vomiting, a severe headache that is worse on sitting up after a spinal, new weakness or numbness that does not wear off as expected, or a high temperature with muscle stiffness. Before surgery, do not proceed if nobody has asked about your health or if you cannot find out who will give the anaesthetic.
This guide is general information and does not replace advice from the doctor treating you. If you would like a specialist to look at your own case, send your reports and photographs: a Clinic-Y coordinator replies within 24 hours, and the case review is free.
Frequently Asked Questions
Is sedation safer than general anaesthesia?
Not necessarily. Light sedation with a fully conscious patient is low risk. Deep sedation can stop breathing or allow stomach contents into the lungs, without the airway protection that general anaesthesia provides. Safety comes from the person giving it and the monitoring used, not from the label.
I have a cold. Can surgery go ahead?
A mild runny nose without fever may be acceptable. A chesty cough, fever, wheeze or a recent significant respiratory infection usually means postponing elective surgery, often by 2 weeks or more, because airway complications are more likely. Tell the team early instead of hoping it passes.
Can long flights before surgery affect the anaesthetic?
Indirectly. You may arrive dehydrated, tired and jet lagged, and long immobility adds to clot risk. Arriving at least a day or two before major surgery allows rest, hydration, tests and an unhurried anaesthetic assessment.
Will I be asked about pregnancy?
Yes. Women of childbearing age are routinely asked, and many hospitals perform a pregnancy test before elective surgery. Planned procedures are normally postponed during pregnancy. It is a standard safety step and applies to everyone in that group.