What Questions Should You Ask About Anesthesia?

Updated November 2025

Beautiful results start with a safe plan—and that plan begins long before the first incision. Anesthesia is the safety backbone of plastic surgery: it affects your comfort, breathing, blood pressure, nausea risk, recovery time, and even whether you go home the same day. Yet many patients focus on the procedure and gloss over the anesthesia conversation. This guide changes that. You’ll learn the key anesthesia types (local, local with sedation/MAC, regional, general), who should administer them, what monitoring is essential, how to reduce nausea and pain, and the questions that reveal whether a practice is truly safety-first. We’ll also cover red flags, a prep checklist, FAQs, and how surgeon credentials and facility accreditation fit into the picture.

Use this as your consultation blueprint so you can make a confident, well-informed decision.

How to Choose a Plastic Surgeon You Can Trust (Anesthesia Starts With Systems)

Board certification (ABPS/ABMS). For plastic-surgery procedures, prioritize surgeons certified by the American Board of Plastic Surgery (ABPS) - recognized by the American Board of Medical Specialties (ABMS). This signals accredited training, rigorous exams, ethical standards, and ongoing competence.

Facility culture and anesthesia team. Safe outcomes rely on more than the surgeon. Confirm that your procedure occurs in an accredited operating facility and that a qualified anesthesia professional (MD anesthesiologist or CRNA per state law/practice model) is present for the entire case—not “as needed.”

Experience with your procedure and health risks. Your surgeon and anesthesia team should be comfortable with your specific operation and your health profile (e.g., BMI, obstructive sleep apnea, diabetes, prior anesthesia issues, clot risk).

Anesthesia 101: Options You’ll Hear About

Local anesthesia Numbing medicine injected into the operative area. Best for very small procedures; you’re awake. Minimal systemic effects; often combined with oral pain/anxiety meds.

Local + sedation (MAC: Monitored Anesthesia Care) You breathe on your own while receiving IV medications for relaxation and pain control. Depth can range from light to deep. Continuous monitoring and capnography are standard when sedation is moderate or deep.

Regional anesthesia Nerve blocks (e.g., chest wall blocks for breast, TAP blocks for tummy) provide targeted pain relief during and after surgery. Often used alongside sedation or general anesthesia to reduce opioid needs.

General anesthesia You’re fully asleep with a secured airway (endotracheal tube or laryngeal mask) and controlled breathing. Allows longer or more complex procedures with complete immobility and airway protection.

Which is “best”? The safest choice depends on the procedure, duration, your health, and the team’s expertise. A safety-focused practice individualizes the plan, explains trade-offs, and adjusts if conditions change.

Questions to Ask During Your Consultation (Anesthesia-Focused)

Topic	Example Question
Who’s in charge	“Who will provide my anesthesia (MD anesthesiologist, CRNA, or a team)? Will they be present for the entire case?”
Type & rationale	“What type of anesthesia do you recommend (local, sedation/MAC, regional, general) and why for my procedure and health profile?”
Airway plan	“How will my airway be managed? If sedation is planned, what’s the backup plan if I need conversion to general anesthesia?”
Monitoring	“What monitoring do you use (ECG, pulse ox, capnography, NIBP, temperature)? Do you use capnography for moderate or deep sedation?”
Nausea & pain	“What’s your PONV (post-op nausea/vomiting) prevention plan? What multimodal pain regimen will reduce opioid use?”
Risk screening	“What is my ASA class and specific risk factors (e.g., OSA, reflux, clot risk)? How are these mitigated?”
Meds & fasting	“Which medications or supplements should I stop or continue? What are the NPO/fasting instructions?”
DVT prevention	“What is your strategy to reduce blood clots (risk scoring, compression devices, blood thinners when indicated, early ambulation)?”
Recovery & discharge	“What are the criteria for discharge (e.g., Aldrete score)? How long will I stay in PACU? Who do I call after hours?”
Emergencies	“What emergency equipment is on site (crash cart, defibrillator)? How often do you run drills, and what is the hospital transfer plan?”
Billing & consent	“How is anesthesia billed and consented? Will I meet the anesthesia provider before the day of surgery?”

Why this table matters: It anchors your discussion to verifiable systems—personnel, monitoring standards, prevention protocols, and escalation plans—so you’re not deciding on comfort alone.

Red Flags to Watch For

• The facility cannot provide proof of accreditation (AAAASF, The Joint Commission/JCAHO, or AAAHC) and last inspection date.
• Vague answers about who provides anesthesia or whether they are present the whole time.
• No mention of capnography during moderate/deep sedation.
• No written plan for PONV prevention, multimodal pain control, or DVT prophylaxis.
• Casual attitude toward fasting or instructions to “just skip breakfast.”
• No clear after-hours contact or discharge criteria; “you’ll be fine” isn’t a plan.
• Reluctance to discuss emergency equipment, drills, or transfer agreements.
• Pressure tactics to book before you’ve met the anesthesia provider or seen the facility standards.

If two or more appear, slow down and seek a second opinion.

How to Prepare for Your Anesthesia Interview (So You Get Straight Answers)

Bring precise medical history. List prior surgeries, anesthesia reactions (you or relatives), medication allergies, heart/lung conditions, reflux, OSA/CPAP use, bleeding/clotting history, diabetes, autoimmune disease, nicotine exposure, alcohol/drug use.

Medication & supplement audit. Some over-the-counter products increase bleeding (e.g., high-dose fish oil, ginkgo, garlic), interact with anesthesia, or raise blood sugar. Ask exactly what to stop and when.

Sleep apnea matters. If you snore loudly, have daytime sleepiness, or use CPAP, tell the team. OSA affects airway decisions, drug choices, and post-op monitoring.

Fasting (NPO) clarity. Get exact cutoffs for solids and clear liquids. Many protocols allow clear liquids up to 2 hours before anesthesia; follow your team’s instructions to the letter.

Logistics. Arrange a responsible adult to drive you home and stay the first night. Prepare a list of questions and a place to take notes; request written instructions.

What Makes a Facility Safe (For Anesthesia)

Accreditation bodies

• AAAASF (American Association for Accreditation of Ambulatory Surgery Facilities)
• The Joint Commission (JCAHO)
• AAAHC (Accreditation Association for Ambulatory Health Care)

What accreditation covers: anesthesia credentials and supervision, medication management, sterile processing, documentation, emergency equipment (defibrillator, crash cart), backup power, and transfer agreements. Ask to see the certificate and the most recent inspection date.

Monitoring standards to expect:

• Continuous pulse oximetry, ECG, non-invasive blood pressure, and capnography during moderate/deep sedation or general anesthesia.
• Temperature monitoring for longer cases.
• Charted vitals at standard intervals and before discharge.

Team readiness:

• Anesthesia provider present for the entire case, with airway equipment sized for you, plus reversal agents and emergency drugs available.
• Staff trained in BLS/ACLS; regular mock codes/emergency drills.

Hospital privileges: Your surgeon’s active hospital privileges add peer-review oversight and a clear emergency pathway, even when surgery is planned entirely outpatient.

Pain, Nausea, and Recovery: Building a Better First 48 Hours

Multimodal pain control Combines different classes of medications and techniques to reduce opioid need and side effects. May include acetaminophen, NSAIDs (if safe for you), gabapentinoids, local anesthetic infiltration, and regional nerve blocks.

PONV (post-op nausea and vomiting) prevention Ask about your risk factors (female sex, prior PONV/motion sickness, opioids, non-smoker, longer surgery) and the antiemetic strategy (e.g., ondansetron + dexamethasone + scopolamine patch as indicated). Hydration matters too.

Airway and breathing after anesthesia If OSA or obesity is a concern, the team may use special airway strategies and extended monitoring. Bring your CPAP if instructed.

Discharge criteria Expect objective measures (e.g., Aldrete score), stable vitals, controlled pain and nausea, ability to tolerate fluids, and a responsible adult escort. You’ll receive written instructions and an after-hours contact number.

DVT/PE Prevention: The Often-Missed Anesthesia Conversation

Risk scoring: Your team should assess clot risk based on surgery type, duration, BMI, hormones, history of clotting, and mobility limits. Prevention bundle: Intermittent pneumatic compression devices during surgery, early ambulation, and chemoprophylaxis (e.g., low-dose anticoagulants) when indicated. Your role: Stay hydrated (per instructions), walk as soon as allowed, and know the warning signs (calf pain/swelling, shortness of breath).

Special Situations to Discuss

• Malignant Hyperthermia (personal/family history). Triggers, precautions, and facility readiness (dantrolene availability).
• Drug interactions. MAO inhibitors, SSRIs/SNRIs, GLP-1 agonists, stimulants; be honest about all substances.
• Pregnancy testing policy. Many centers require same-day testing for those who could be pregnant.
• Diabetes. Insulin and oral agent adjustments; glucose monitoring plan.
• Nicotine and vaping. Vasoconstriction affects wound healing and anesthesia risk; ask about cessation timelines.

How to Use This Information If You Feel Rushed

• Reset the pace: “Before we choose a date, I need 10 minutes on anesthesia, monitoring, and emergency plans.”
• Ask for documents: “Please send accreditation proof, anesthesia credentialing, and discharge criteria.”
• Schedule a follow-up: A dedicated anesthesia Q&A (virtual is fine) with the provider who will be present for your case.
• Decline same-day commitments: “I don’t book on the day of consult; I’ll review the anesthesia plan and follow up.”

FAQs (mark with FAQPage schema in your CMS)

Is general anesthesia safer than sedation? Neither is “automatically safer.” The safest choice depends on the procedure, your health, and the team’s expertise. What matters is appropriate selection, qualified providers, and vigilant monitoring.

Do I meet the anesthesia provider before surgery? In a well-run practice, yes—at least virtually. You’ll review your history, meds, risks, and the plan.

Can I eat or drink before anesthesia? Follow your team’s NPO instructions exactly. Many protocols allow clear liquids up to two hours before anesthesia, but your instructions may differ—do not self-decide.

How can I avoid nausea? Share any history of PONV or motion sickness. Ask for a multi-drug prevention plan, good hydration, and opioid-sparing pain control.

Who should avoid office-based anesthesia? Patients with significant uncontrolled disease, very high BMI with OSA, or complex airways may be safer in a hospital or higher-acuity center. Your team should individualize this call.

Your Anesthesia & Safety Checklist

• I verified ABPS board certification and hospital privileges.
• I confirmed facility accreditation (AAAASF/JCAHO/AAAHC) and saw the inspection date.
• I know who provides anesthesia and that they’ll be present for the entire case.
• I understand the type of anesthesia recommended and why.
• I reviewed the airway/backup plan and monitoring used (including capnography for moderate/deep sedation).
• I received a PONV prevention and multimodal pain plan tailored to me.
• I was screened for DVT risk and given a prevention plan.
• I have exact medication/fasting instructions and a list of what to stop and when.
• I know discharge criteria, after-hours contacts, and transfer plans.
• I obtained an itemized quote including anesthesia fees and signed a clear anesthesia consent.

Find Your Match

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