You may meet your anaesthetist in a preoperative Assessment Clinic. Otherwise, you will meet shortly before you enter the Operating Room. This meeting may take place on a ward, in an admissions unit, or in a holding area outside the Operating Room.

Your anaesthetist will review information contained in your hospital record or chart, such as the results of any tests you have undergone. He or she will ask you some additional questions, such as your, or your relatives’, experience with anaesthetics. Your anaesthetist will talk to you about possible choices of anaesthetic, such as between general and regional or local anaesthesia, and about any specific problems or concerns you have. In addition, your anaesthetist will discuss with you the different choices for postoperative pain management.

After this, your anaesthetist will examine you, by looking at your mouth, your teeth, and the veins of your hands, arms, and neck, and may listen to your chest. If you are to have a regional or local anaesthetic, your anaesthetist may also look at the area of your body where the anaesthetic is to be injected, such as the small of your back.

As the last part of pre-anaesthetic assessment, the anaesthetist makes an overall evaluation of you and assigns a numerical classification. This is known as the ASA Class, where ASA stands for American Society of Anesthesiologists. Although it was developed in the United States, the ASA Class is now used worldwide as a way of classifying patients according to how well or ill they are. This classification refers only to your physical condition at the time of assessment. The higher the score, the less well you are. An ‘E’ after the appropriate classification designates that you are to undergo an emergency operation.

• ASA Class I: A normal healthy patient
• ASA Class II: A patient with mild systemic disease
• ASA Class III: A patient with severe systemic disease limiting activity but not incapacitating
• ASA Class IV: A patient with incapacitating systemic disease that is a constant threat to life
• ASA Class V: An extremely ill patient who is not expected to live 24 hours with or without an operation.

The ASA classification is not a score of how risky the anaesthetic might be for you. However, the ASA Class has been shown to correlate with the risk of complications occurring after the operation, particularly the risk of dying. This risk is related to the operation performed and how well or ill a patient was before the procedure (or a patient’s preoperative physical condition). In general, there is very little contribution from the anaesthetic to the chance of a patient dying after a procedure.

Ask Questions

This is your opportunity to ask about your anaesthetic. Even though you may think that the time for questions is short, you should ask whatever you want and make sure that all your questions are answered.