When people think about surgery, they usually only picture the surgeon holding the scalpel. But behind every safe operation, there’s another superhero working quietly in the background: the anaesthetist.
In contrast to popular opinion, an anaesthetist’s job is not just to “put you to sleep”, but to make sure your body is ready to handle the stress of surgery, and to keep you safe and comfortable throughout.
One of the most important parts of their role happens before you even step into the operating theatre — preoperative preparation.
Let me walk you through what this means, why it matters and how you can help make your surgery smoother.
Step 1: Understanding you as a whole person
When an anaesthetist meets you before surgery, they’re not just interested in your operation. They want to know about you:
- Do you have high blood pressure, diabetes, epilepsy or asthma?
- Have you ever had problems with anaesthesia before?
- What medications or supplements are you taking?
- Do you smoke, drink or use recreational substances?
These details help them tailor your anaesthetic plan. Think of it like inputting the details of your destination into a GPS before a road trip – they need the full map to guide you safely.
Step 2: Optimising your health
Sometimes surgery isn’t urgent, and there is time to get you into the best possible shape:
- Blood pressure and blood sugar control: Stable levels mean fewer complications.
- Smoking cessation: Even quitting a few weeks before your procedure reduces risks to your lungs and heart.
- Weight and fitness: A stronger body recovers more easily.
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It’s not about being perfect – it’s about giving your body the best fighting chance to come out of surgery without complications.
Step 3: Fasting and fluids
One of the most common questions I hear is: “Why can’t I eat or drink before surgery?”
The reason is safety. When you’re unconscious, your protective reflexes switch off. If your stomach still contains food or liquid, there’s a risk it could travel into your lungs. That can be life-threatening.
So, the usual rule is: No solid food for six hours before surgery, and only clear fluids (like water or black tea) allowed up to two hours before surgery.
We are not being cruel – we are being careful.
Step 4: Medication – What to take and what to skip
Not all tablets that you usually take can be taken on the morning of surgery.
For example, blood pressure meds are usually continued, while blood thinners may need to be paused for obvious reasons.
Diabetes medication doses often need adjusting, because of the required fasting ahead of a procedure.
This is why your pre-operative consultation is so important, as it allows your doctor to give you clear, personalised instructions.
Step 5: Calming the mind
Let’s be honest: surgery is scary. Feeling anxious is normal.
Part of the anaesthetist’s job is to reassure you, answer questions and explain what to expect.
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Sometimes, a mild sedative is prescribed to take the edge off. But often, just having a real conversation about what will happen helps the most.
But why does all this preoperative preparation matter?
Well, it isn’t just ticking boxes. It’s about making surgery safer, smoother and easier to recover from. Every small detail, from controlling your blood pressure to not sneaking that last-minute mageu or sandwich, adds up to a safer surgical journey and recovery.
As an anaesthetist, I often say that the operation starts long before the first incision. Preparing you well is like laying a strong foundation before building a house. It may feel like a lot of rules and questions, but every step has one goal: to keep you safe.
So, if you’re ever heading for surgery, remember: preparation isn’t about restriction; it’s about protection.
And your anaesthetist will be there, watching over you the whole way, like a guardian angel, making sure that your body is comfortable, pain free and handling the surgical procedure well.
- Dr Maistry is an anaesthetist in Johannesburg. She writes in her personal capacity
