Medical Oncologist
CION Cancer Clinics
The pre-anaesthetic check-up explained | CION Cancer Clinics
A pre-anaesthetic check-up is a meeting with the anaesthetist before your operation. They ask about your illnesses, medicines and habits, examine you, and read your tests. Then they plan your anaesthesia and tell you what to do about food and medicines. It exists so that problems are found and fixed early, and not on the morning of surgery. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
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Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
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On this page
- What is a pre-anaesthetic check-up?
- What actually happens during the check-up?
- Why does the anaesthetist ask so many questions?
- What do the words on the check-up form mean?
- What do patients often misunderstand about the check-up?
- What happens after you leave the check-up?
- Common questions about the pre-anaesthetic check-up
The short answer
What is a pre-anaesthetic check-up?
It is a meeting with the anaesthetist, the doctor who puts you to sleep and keeps you safe during the operation. They review your health, tests and medicines, examine you, and plan your anaesthesia before the day.
Why it happens before the operation, not on the day
Finding a problem on the morning of surgery often means the operation is cancelled at the last minute. Seeing you earlier gives time to control sugar or blood pressure, order an extra test or ask a heart doctor for an opinion. It turns surprises into a plan.
Who you will meet
Usually an anaesthetist, sometimes with a nurse who records your details first. You may hear it called the PAC, or the anaesthesia clinic. The anaesthetist you meet may not be the one in theatre, but your notes travel with you.
What to bring with you
Bring every test report, all your medicine strips or prescriptions, notes from any heart, lung, kidney or diabetes doctor, and details of past operations. If you use an inhaler, a CPAP machine at night or a hearing aid, mention it. A folder with everything in date order saves time and avoids repeat tests.
What this page cannot tell you
It cannot tell you whether you will be cleared. That depends on your own results and examination, and on the operation planned.
Bring a family member. The anaesthetist will give instructions about food and medicines, and two people remember them better than one.At the appointment
What actually happens during the check-up?
Your history
You are asked about illnesses, past operations, previous anaesthesia, allergies, smoking, alcohol and every medicine you take. Bring the strips or prescriptions, not only the names.
The examination
Your blood pressure, pulse, weight, heart and lungs are checked. The anaesthetist looks inside your mouth, at your teeth and at how far your neck moves.
Reviewing the tests
Blood tests, ECG, chest X-ray and any echo or lung tests are read together. Extra tests may be ordered if a result needs a closer look.
The plan and your questions
The type of anaesthesia, pain relief after surgery and any added risk are explained. You are told what to do about food and medicines before the day.
Not sure whether this applies to you?
Ask an oncologistThe questions
Why does the anaesthetist ask so many questions?
Each question links to something that changes how you are looked after. Honest answers keep you safer.
Medicines
Blood thinners, diabetes medicines and some blood pressure tablets need a clear plan around surgery. The timing is set by your doctors, so never stop one on your own.
Snoring and sleep
Loud snoring, or stopping breathing in sleep, can affect how the airway behaves under anaesthesia and after it.
Teeth
Loose teeth, caps and dentures matter when a breathing tube is placed. Tell the team about any tooth that moves.
Habits
Smoking, alcohol, gutka and tobacco chewing all change how the lungs, liver and wounds behave. Say what you use, honestly. No one is there to judge.
Past anaesthesia
A bad reaction in you, or in a close relative, is important. So is severe sickness after a previous operation.
Also mention
- Any drug or latex allergy
- Recent chemotherapy
On your PAC form
What do the words on the check-up form mean?
- ASA grade
- A rating of your general health before surgery. A higher grade means more health problems for the team to plan around.
- Fit for surgery under GA
- You are cleared for general anaesthesia, where you are fully asleep.
- Regional or spinal anaesthesia
- An injection that numbs part of the body. It may be used alone or with general anaesthesia.
- NBM
- Nil by mouth. Nothing to eat or drink from the time written on your instructions.
- High risk
- Your risk is higher than usual. It means extra care is planned, not that surgery is refused.
- Review after optimisation
- Something needs to be improved first, and you will be seen again.
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Commonly believed
What do patients often misunderstand about the check-up?
"It is just a formality before the operation."
It is one of the most important safety steps. Problems found here are much easier to handle than problems found in the operating theatre.
"I should hide my drinking or smoking."
Hiding it puts you at risk. Alcohol and tobacco change how anaesthesia works and how the body recovers. The anaesthetist needs the truth to plan safely.
"If I am cleared once, I never need another check."
If the operation is delayed, or your health changes, a fresh review may be needed. Chemotherapy, a new infection or a hospital stay can all change the picture.
"Stopping all medicines before surgery is safer."
Stopping some medicines suddenly can be dangerous. Some must continue, some are paused, and some are swapped. Follow only the written plan from your doctors.
After the check-up
What happens after you leave the check-up?
You usually leave with a clearance, a list of things to improve first, or a referral to another specialist. Ask which of these applies to you before you go home.
If you are cleared
You will be given instructions about when to stop eating and drinking, which medicines to take on the morning of surgery, and what to bring. Ask for them in writing. Ask what to do if you develop a fever, cough or loose motions before the date.
If more is needed
A heart or chest doctor's opinion, better sugar control or treatment for an infection may come first. The operation date can move. That is frustrating for families, and it is usually done to make surgery safer.
When the team is unsure
Some people have serious heart or lung disease where the risks of a large operation are high. The surgeon and anaesthetist then talk it through with you, and may discuss a smaller operation or another treatment.
Questions worth asking before you leave
Am I cleared, or is something still pending? When should I stop eating and drinking? Which medicines do I take on the morning of surgery, and which do I hold? Whom do I call if I fall ill before the date? Will I need to be seen again if the operation is delayed? Having these answers written down saves a worried phone call later.
Did you know
Your check-up clearance is linked to your health at that time. If your operation is pushed back for a long period, ask whether the anaesthetist needs to see you again before the new date.
Questions we are asked
Common questions about the pre-anaesthetic check-up
Do I need to be fasting for the check-up?
Usually not for the meeting itself. You may need to fast if blood tests are being taken the same day. Ask when the appointment is booked. Take your usual medicines unless you have been told otherwise, and bring them with you so the anaesthetist can see exactly what you take.
How long does the check-up take?
The meeting itself is often short. The whole visit can take longer if tests are done the same day or there is a queue. Keep the day free if you can. Bring snacks for a family member waiting with you, and your reports in one folder.
Should I stop my blood thinner before surgery?
Do not stop it on your own. Blood thinners such as aspirin, clopidogrel or warfarin are often paused around surgery, but stopping some of them suddenly can cause a stroke or heart attack. The surgeon, anaesthetist and the doctor who prescribed it agree the timing and tell you.
Will I be fully asleep during the operation?
For most major cancer operations, yes. Some operations use a spinal or regional injection, sometimes with sedation, and some combine both. The anaesthetist explains which is planned for you and why. Ask about pain relief after surgery at the same time.
My mother cannot hear well or speak English. What should we do?
Come with her, and tell the staff at the start. Doctors and nurses can speak slowly or in Telugu, Hindi or Urdu where possible. Answer for her only when she cannot answer herself, and make sure she understands the plan too.
Can the check-up be done from a district hospital?
Tests can often be done nearer home, but the anaesthetist of the hospital doing the operation usually needs to see you in person. Ask whether you can bring local reports to reduce the number of trips to Hyderabad.
What if I catch a cold before the operation?
Call the team. A mild cold may not change anything, but a fever, a chest infection or a bad cough can make anaesthesia less safe. The operation may be moved until you recover. Do not wait until the morning of surgery to mention it.
Is the check-up covered by Aarogyasri or insurance?
It is often covered when it is part of an approved cancer surgery plan. Aarogyasri, CGHS, ECHS, EHS and cashless insurance each have their own rules. Call the helpline with your card or policy details and the team can check what applies before your visit.
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Dr. C. Raghavendra Reddy
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Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
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Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
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Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
Surgical Oncologist
Surgical Oncologist
Dr. Vinay Mamidala
MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)
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Hematologist
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Dr. Vajja Sandeep Kumar
MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology
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Sources
- Royal College of Anaesthetists — Patient information
- NHS — General anaesthesia
- NICE — Routine preoperative tests for elective surgery (NG45)
- American Cancer Society — Cancer Surgery
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
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Tests Done Before Cancer SurgeryThe tests the anaesthetist will read at the check-upAnaesthesia for Cancer SurgeryThe types of anaesthesia and what to expectMedicines Around Cancer SurgeryWhy some medicines are paused and who decidesAre You Fit Enough for Cancer Surgery?How the whole fitness decision is made
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