A thorough preoperative evaluation will provide both anesthesiologist and surgeon valuable information which may alter the course of patient care. Anesthetic preoperative evaluation is composed of four components: patient history, physical examination, laboratory studies, and anesthetic plan. A review of systems examination is usually a useful approach; this includes assessment of cardiac, pulmonary, renal, hepatic, neurological, gastrointestinal, endocrinological/metabolic, musculoskeletal, psychiatric, gynecological and obstetric organ systems. For ENT surgery, most of the time, anesthetic-related reasons for cancellation are due to recent upper respiratory infection or non-compliance with preoperative fasting guidelines. Evaluation of patient capacity sometimes enters into the process of informed consent or refusal in the elderly. Traditionally, anesthesiologists often consider perioperative cardiac and pulmonary events relatively controlled and easily reversible. While most of the ENT procedures are in the low surgical risk category, some of the large elective ENT operations are considered intermediate-risk surgery.

Anaesthesia for ENT surgery has to specifically address the problems of a shared airway, perioperative bleeding and postoperative pain and discomfort. Tonsillectomy is one of the common operations. Endotracheal anaesthesia has been the standard for many years, but this trend has changed since the introduction of reinforced Laryngeal mask airways (LMAs). The common drugs used for pain control following tonsillectomy are opioids, paracetamol and NSAIDs. Cataract surgery is one of the main areas where anaesthetists are involved in ophthalmic surgery. The increasing use of topical anaesthesia for cataract extraction has caused renewed interest in analgesia and sedation during cataract surgery. Dental anaesthesia aims to provide an unrestricted operating field, a safe stable airway and protection from aspiration of blood and fluid from the mouth. The reinforced LMA was specifically designed for use in oral surgery, and has extra flexibility and increased length than the classic LMA.