What to Go Over Before You Go Under

Anesthesia, although safer today than ever, is still a high-risk business, so doctors and patient advocates alike suggest patients ask to meet the provider in advance. They should discuss their medical history and any past experiences with anesthesia.

Charles Inlander, founder of the People’s Medical Society, suggests patients develop “something of a personal relationship with that person because you don’t want that anesthesiologist to be thinking of you just as ‘that 8:45 a.m. surgery.’ ” You have the right, he says, to request that someone else give you your anesthesia “if you don’t feel comfortable after speaking to that person.”

Here are some basic questions a patient can ask before undergoing surgery.

* Is the facility accredited by one of four major bodies--the Joint Commission on Accreditation of Healthcare Organizations, the Accreditation Assn. for Ambulatory Health Care, the American Assn. for Accreditation of Ambulatory Surgery Facilities or the Institute for Medical Quality? And is it accredited to perform surgery and give anesthesia? * Who will administer the anesthesia, and what are his or her qualifications? What type of anesthesia will be administered? How long has he or she been doing this kind of anesthesia?

* Depending on who administers the anesthesia: Is the anesthetist a licensed registered nurse who has also passed the national examination to be a nurse-anesthetist? Is the anesthesiologist certified by the American Board of Anesthesiology? If the procedure is being performed in an office, is the individual certified to perform it in a hospital or outpatient surgery center?

* For surgeries in a doctor’s office, are the anesthesia machine and monitors modern and equivalent to equipment that would be used if the operation were taking place in a hospital or ambulatory surgery facility?

* If the surgery is for a child, does the facility have suitable equipment, such as smaller defibrillators?

* What equipment and medications are available for emergencies? Is there a crash cart, for example?