What is a pre-operative assessment for?

A pre-operative assessment checks that you are as ready and safe as possible for surgery and anaesthesia. The team reviews your medical history, medications, allergies, and previous anaesthetic experiences, examines you (including your heart, lungs, and airway), and may arrange tests such as blood work or an ECG. They then plan the safest anaesthetic and pain relief for you and identify anything that needs optimising beforehand. Coming prepared with an accurate medication list and your history makes this assessment more thorough and useful.

Why do I have to fast before an anaesthetic?

Fasting reduces the risk of stomach contents coming back up and entering your lungs while you are under anaesthesia, a rare but serious complication. That is why you are given specific instructions, typically no food for several hours beforehand, with clear fluids allowed up to a stated time. These rules are strict for safety, and not following them can lead to your surgery being delayed or postponed. If your fasting instructions are unclear, ask your team before the day rather than guessing.

Which medications do I stop before surgery?

This is individualised and decided at your pre-operative assessment, so never stop or continue medicines on assumption. Blood thinners (anticoagulants and antiplatelets such as warfarin, DOACs, aspirin, or clopidogrel) often need careful timing because of bleeding risk, and some diabetes medicines are adjusted around fasting. Many other medicines are continued as normal, including on the morning of surgery. Bring a complete list, flag your blood thinners clearly, and get specific instructions on what to take and what to pause, and when.

What should I tell the anaesthetist about previous anaesthetics?

Tell the anaesthetist about any problems you or close family members have had with anaesthesia, as some reactions can run in families. This includes severe or prolonged nausea and vomiting, difficulty waking, breathing or airway problems, allergic reactions, and any rare but serious reactions you were told about. Also mention if you have ever been told you were a 'difficult intubation'. This history helps the anaesthetist plan a safer, more comfortable anaesthetic tailored to you, so it is worth gathering these details before your assessment.

How to Prepare for an Anaesthetist / Pre-Operative Assessment

Quick answer: Bring a complete, accurate list of every medication and supplement (including blood thinners, diabetes medicines, and herbal products), details of any previous anaesthetics and how you or close family reacted, all your allergies, and your other medical conditions. The pre-operative assessment exists to make your surgery and anaesthetic as safe as possible — and following the fasting and medication instructions you are given is one of the most important things you can do.

Before planned surgery, you will usually have a pre-operative assessment with an anaesthetist or a pre-admission team. This is not a formality — it is where your safety for the operation is planned in detail. The two things that make it go well are an accurate medication history and following the fasting and medication instructions exactly. This guide helps you prepare for that conversation.

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What to Bring to Your Pre-Operative Assessment

Full medication list: every prescription, over-the-counter medicine, and supplement, with doses. A weekly pill organiser or an up-to-date list is ideal.
Blood thinners flagged clearly: anticoagulants and antiplatelets (for example warfarin, DOACs, aspirin, clopidogrel) — these often need careful timing
Previous anaesthetic history: any problems you or close relatives had with anaesthesia (including severe nausea or reactions)
Allergies: medicines, latex, and reactions you have had
Your conditions: heart, lung, kidney, diabetes, sleep apnoea, and recent test results. A appointment notebook keeps them together.

Fasting and Medications — Why the Instructions Matter

You will be given specific fasting instructions (typically no food for several hours and clear fluids up to a stated time). These reduce the risk of stomach contents entering the lungs under anaesthesia and are strict for good reason. You will also be told which regular medicines to take on the morning of surgery and which to pause — this is individualised, especially for blood thinners and diabetes medicines. If anything is unclear, ask before the day, never guess.

What the Assessment May Involve

Step	Purpose
Medical history review	Identify conditions that affect anaesthesia and recovery
Examination	Including heart, lungs, and airway assessment
Tests	Bloods, ECG, or others depending on you and the surgery
Anaesthetic plan	The type of anaesthesia and pain relief, discussed with you
Fitness assessment	An overall ‘fitness for surgery’ judgement (often described with an ASA grade)

Helpful for this appointment

weekly pill organiser — to bring an accurate, up-to-date medication list, which is central to a safe anaesthetic
appointment notebook — to note your questions, conditions, and the instructions you are given

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Questions to Ask

Which of my medicines should I take on the morning of surgery, and which should I stop — and when?
What are my exact fasting instructions?
What type of anaesthetic is planned, and what are the risks for me?
How will my pain be managed afterwards?
Do my other conditions (or sleep apnoea) need any special precautions?

Regional Notes

Singapore: Pre-operative assessment clinics at public and private hospitals review fitness and medications before elective surgery.

Australia: Pre-admission clinics coordinate assessment; your anaesthetist may contact you before the day for complex cases.

United States: Pre-operative or pre-anaesthesia evaluation is standard before elective surgery; instructions come from the surgical and anaesthesia teams.

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Medical Disclaimer: This guide is for informational and preparation purposes only. It does not constitute medical advice, diagnosis, or treatment. Always consult a qualified medical professional for guidance specific to your situation.