Many patients meet their anesthesiologist only a few minutes before surgery. So it can look as if our job starts there. Actually, a lot has already happened before you enter the operating room.
We are looking at your medical history, your medicines, previous anesthetics, allergies, heart and lung problems, diabetes, sleep apnea, recent illness, and anything that may affect surgery. We also think about the operation itself. How long will it take? Is major blood loss expected? What position will you be in? Will you need a nerve block? What kind of pain relief will help afterward? Will you need closer monitoring during or after surgery?
Every answer can change the plan. A patient taking blood thinners may need special precautions. Someone with severe sleep apnea may need closer observation. A patient who had a difficult airway in the past may need extra equipment ready before anesthesia begins.
Sometimes we also have to ask a harder question: Is today really the safest day to proceed? If a new medical problem has appeared, delaying an elective operation may sometimes be safer than going ahead simply because the surgery is already booked.
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There is also a lot of preparation that patients never see. Before anesthesia starts, the team checks the anesthesia machine, monitors, oxygen, medications, airway equipment, intravenous access, and emergency drugs. If special equipment, blood products, or extra monitoring may be needed, we try to have them ready in advance.
This is an important part of anesthesia care. Good anesthesia is not only about reacting quickly when something goes wrong. It is also about thinking ahead so that fewer things go wrong in the first place.
Patients sometimes ask, “Will you be there during the whole operation?” Yes. But our responsibility starts before the operation and continues after it.
So when your anesthesiologist asks several questions before surgery, we are not simply completing a form. We are already planning how to look after you.
By the time you enter the operating room, an important part of your anesthesia care has already begun.
Girishkumar Modi is a senior specialist anesthesiologist at Tawam Hospital in the United Arab Emirates. His clinical practice includes regional anesthesia, trauma and orthopedic anesthesia, neuroanesthesia and spine anesthesia, obstetric anesthesia, pediatric anesthesia, perioperative medicine, and the management of complex surgical patients. He serves as faculty in an anesthesiology residency program accredited by the Accreditation Council for Graduate Medical Education International, where he contributes to resident teaching, clinical supervision, assessment, and mentorship. He also contributes to trauma-service development and multidisciplinary perioperative care.
His academic interests include perioperative physiology and pharmacology, regional anesthesia, total intravenous anesthesia, acute pain management, point-of-care coagulation and hemostasis, medical education, health care economics, and perioperative patient safety. He is active in clinical research, medical writing, and peer review, with publications spanning anesthesiology, pharmacology, perioperative medicine, regional anesthesia, point-of-care coagulation and rotational thromboelastometry, and medical education. His work has appeared in the Mathews Journal of Anesthesia, the Journal of Anesthesia & Pain Medicine, and Anaesthesia, with abstracts presented at the Association of Anaesthetists Winter Scientific Meeting in London and the Integrated Anesthesia and Comprehensive Care Conference in Abu Dhabi.
He also writes commentary on clinical judgment, artificial intelligence, and patient readiness for surgery, including rapid responses in The BMJ such as “Medicine is not a 64-square board: Human oversight requires independent judgment” and “AI systems need a tested exit plan.”
