Before surgery, an anesthesiologist will ask you a detailed set of questions covering your medical history, medications, allergies, lifestyle habits, and even your dental health. The goal is to build a safe, personalized anesthesia plan. Most of this happens during a pre-anesthesia assessment, which may take place days before your procedure or on the day of surgery itself. Knowing what to expect can help you prepare accurate answers.
Heart and Lung History
Some of the first questions focus on your cardiovascular and respiratory health, because the heart and lungs do the heavy lifting while you’re under anesthesia. Expect to be asked whether you have, or have ever had, chest pain or tightness, an irregular heartbeat, a pacemaker or defibrillator, high blood pressure, blood clots in your legs or lungs, or any circulation problems. Each of these conditions changes how your body responds to anesthesia drugs and how aggressively the team needs to monitor you during the procedure.
On the respiratory side, you’ll be asked about asthma, emphysema, chronic bronchitis, and whether you experience shortness of breath at rest. The anesthesiologist also wants to know if you’ve had an upper respiratory infection (a cold) within the past two weeks, since even a mild one can make your airways more reactive and increase the risk of complications like spasm or coughing during intubation.
Sleep Apnea Screening
Sleep apnea is a major concern for anesthesiologists because it affects how easily they can manage your airway once you’re sedated. Many practices use a standardized tool called the STOP-Bang questionnaire, which asks eight quick questions: Do you snore loudly? Do you often feel tired or sleepy during the day? Has anyone observed you stop breathing while asleep? Do you have high blood pressure? Then four additional factors are checked: your BMI, age, neck circumference, and sex. A high score flags you as someone who may need special airway precautions or modified monitoring after surgery.
If you already use a CPAP machine at night, bring that up. The anesthesiologist will note it and may ask you to bring the device to the hospital for use in recovery.
Kidney, Bladder, and Other Organ Function
You’ll be asked about kidney or bladder disorders, whether you’re on dialysis (and your schedule), and whether you’ve ever had difficulty urinating after a previous anesthesia. Kidney function directly affects how quickly your body clears anesthesia drugs, and a history of post-anesthesia urinary retention tells the team to watch for it again.
Your Full Medication List
This is one of the most important parts of the conversation. The anesthesiologist needs to know every prescription drug, over-the-counter medication, and supplement you take. Two categories get the most attention:
- Blood thinners and pain relievers. Drugs like warfarin, clopidogrel, aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve) all affect how your blood clots. Many need to be stopped days before surgery to reduce bleeding risk. Even common anti-inflammatory pain relievers you might not think twice about can be an issue.
- Herbal supplements. Several popular supplements interfere with anesthesia or clotting. Fish oil, garlic, ginkgo biloba, ginger, St. John’s Wort, kava kava, valerian, vitamin E, and high-dose vitamin C are all on the list of products your team needs to know about. Echinacea and green tea are also flagged.
Birth control pills, estrogen replacement therapy, and estrogen patches or creams may also need to be discussed, since they can increase clotting risk during surgery.
GLP-1 Medications Like Ozempic and Mounjaro
If you take a GLP-1 receptor agonist for diabetes or weight loss (semaglutide, tirzepatide, dulaglutide), expect a specific question about it. These drugs slow how fast your stomach empties, which raises the risk of food still being in your stomach when anesthesia begins. Current guidelines from anesthesia societies in Australia, New Zealand, and elsewhere recommend a clear-liquid-only diet the entire day before surgery rather than simply stopping the medication early. Stopping a long-acting GLP-1 drug for one to two weeks doesn’t reliably return gastric emptying to normal, so diet modification the day before is the primary safety measure.
Allergies and Food Sensitivities
You’ll be asked about allergies to medications, latex, and specific foods. The food question isn’t random. One of the most commonly used anesthesia drugs contains soybean oil and egg yolk lecithin. If you have an egg or soy allergy, the anesthesiologist needs to know so they can choose an alternative. Latex allergy matters because surgical gloves and some equipment contain latex. Any history of an allergic reaction during a previous medical procedure is especially important to mention, even if you’re not sure what caused it.
Previous Anesthesia Experiences
The anesthesiologist will ask whether you or any blood relative has ever had a bad reaction to anesthesia. This includes prolonged grogginess, severe nausea, difficulty waking up, or a dangerous reaction called malignant hyperthermia, a rare inherited condition where the body overheats rapidly under certain anesthesia gases. If a close family member experienced an unexplained high fever or muscle rigidity during surgery, that’s critical information. The anesthesiologist will avoid the triggering agents entirely.
You may also be asked whether you’ve ever been told you were difficult to intubate, meaning a breathing tube was hard to place. This changes the equipment and techniques the team prepares.
Alcohol, Tobacco, and Cannabis Use
These questions aren’t about judgment. They directly affect how much anesthesia you need and how your body handles it. Be honest, because inaccurate answers can lead to under-dosing or unexpected complications.
Cannabis use has a well-documented effect on anesthesia dosing. Two large meta-analyses, one covering over 2,200 patients and another over 4,100, found that regular cannabis users require significantly higher doses of intravenous anesthesia drugs to reach the same level of sedation. A separate prospective study showed cannabis users also needed higher doses of sedatives and pain medications. The anesthesiologist will want to know what type of cannabis you use, how often, the route (smoking, edibles, vaping), and when you last used it.
Tobacco use increases airway reactivity and mucus production, raising the chance of coughing or breathing complications during surgery. Alcohol use affects liver metabolism, which changes how quickly you process anesthesia drugs. Heavy or daily drinking is especially important to disclose because withdrawal effects can emerge during a hospital stay.
Dental Health and Airway Assessment
This one surprises many people. The anesthesiologist will ask about loose teeth, caps, crowns, bridges, dentures, and any recent dental work. The reason: placing a breathing tube requires a laryngoscope, a tool that levers against the upper teeth. Dental damage is one of the most common minor injuries from general anesthesia, ranging from chipped enamel and cracked crowns to, in rare cases, a tooth being knocked out entirely. If you have fragile dental work or loose teeth, the team can use protective guards or alternative airway techniques. Mentioning it ahead of time is the simplest way to avoid a preventable problem.
The anesthesiologist will also do a quick physical exam of your mouth and jaw, checking how wide you can open, the size of your tongue relative to your throat, and neck mobility. These observations help predict whether intubation will be straightforward or require special equipment.
Fasting Instructions
Near the end of the conversation, you’ll be given clear fasting instructions, or asked to confirm you’ve followed ones already provided. The standard rule, endorsed by both American and European anesthesia societies, is no solid food for at least six hours before anesthesia and no clear liquids for at least two hours. Clear liquids include water, black coffee, tea, broth, and pulp-free juices like apple juice. Milk, protein shakes, and anything opaque do not count as clear liquids.
Fasting matters because if your stomach has food in it when you go under, there’s a risk of vomiting and inhaling stomach contents into your lungs. At the same time, fasting far longer than necessary isn’t ideal either. Research shows that adults who fast well beyond two hours for liquids are more likely to be dehydrated, which can cause a drop in blood pressure when anesthesia is induced. Sticking to the recommended windows, not longer, gives you the safest balance.
How to Prepare for These Questions
Before your pre-anesthesia visit, put together a written list of every medication and supplement you take, including doses. Note any past surgeries and what type of anesthesia was used, if you know. Write down any reactions you’ve had to medications and whether any family members have had anesthesia problems. If you use cannabis, alcohol, or tobacco, be ready to discuss how much and how often. Bringing this information with you, rather than trying to remember it on the spot, makes the assessment faster and more accurate.