Why Your Anesthesiologist Wants to Look Inside Your Mouth and What They Have in Common with Your Grandmother!

(Disclaimer:  The views in this blogpost are our personal views and do not reflect the views of our institutions. This does not substitute medical advice. Please be evaluated by a physician as necessary.)

  • When is the last time you had food?
    • Like your mother and grandmother who are always wondering if you’ve eaten, your anesthesiologist will also want to know if you’ve eaten! More specifically they want to know when you’ve eaten. Anesthesia medication can cause you to become so relaxed that sometimes food can come up from your stomach. It is important for enough time to have passed from your last meal to when you receive anesthesia to allow enough transit time for the food to be emptied from your stomach and into your intestines. The latest you can have a full meal is 8 hours before your surgery time. Occasionally a light meal (i.e. toast) may be allowed up to 6 hours before surgery. The good thing is that clear liquids empty quicker than solid foods and so they can be ingested for up to 2 hours before surgery. Clear liquids can include water, black coffee (no milk or creamer!), juice without pulp, and even sports drinks like gatorade! 
  • What allergies do you have? 
    • Your anesthesiologist may give you many medications during your surgery often including pain medication, muscle relaxants, sedatives, and antibiotics. We will ask you if you are allergic to any medications so we can avoid those medications and assess for interactions with other medications. Very rarely some fruit allergies may even be associated with latex sensitivity!
  • Any issues with anesthesia before?
    • Although most people do not have any problems with anesthesia, there are some people who may have issues including post-operative nausea and vomiting (PONV), shivering, prolonged muscle relaxation, difficulty with breathing tube placement or other situations. One of the more common ‘side effects’ seen with anesthesia is PONV. The risk factors for PONV include female patients, non-smokers, use of opioids in the perioperative period, history of PONV/motion sickness and others. If you have had episodes of PONV, your anesthesiologist can avoid medications that may be more likely to cause PONV and change your anesthetic plan accordingly.
  • Do you smoke, drink alcohol, or use illicit drugs?
    • We don’t judge! It is crucial that your anesthesiologist knows about recreational drug use. All recreational drugs can have some sort of impact on your heart and lungs and can possibly interact with medications that are in your anesthetic plan. Whether you use cocaine or heroin or medical marijuana, we want to know! This allows your anesthesiologist to safely anticipate any physiologic changes associated with these drugs when mixed with other medications. It is important to tell your anesthesiologist when you used them last and how much.
  • They’ll want to look into your mouth!
    • “Open your mouth and stick your tongue out!” Patients are often surprised to hear their anesthesiologist say this but actually this is one of the most important parts of the physical exam that he/she does. This examination of your mouth is to assess for how much of the inside of your mouth we can see which is correlated with how easy or possibly challenging it may be to place a breathing tube. If there are any anatomical signs that there may be difficulty with breathing tube placement, it is best to have additional equipment necessary.