Concierge anaesthesia · UK
General anaesthetic — what actually happens, honestly.
A plain-English guide to being put to sleep for surgery — pre-assessment, fasting, induction, airway, emergence, recovery and the real risks, written for UK patients and aligned with the Royal College of Anaesthetists.
Why patients choose us
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A consultant anaesthetist, named in advance
Not a rota anaesthetist you meet on the trolley. A named consultant, a proper pre-assessment, and the plan explained before the day.
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Regional and TIVA options on the table
A block or a spinal can spare you a full GA — or make the recovery lighter. We say so before you sign the consent form.
- 03
Independent, and free
We are paid by no hospital, so the recommendation is impartial and the anaesthetist is chosen on record and rapport, not referral fees.
Indicative pricing
What a private consultant anaesthetic costs in the UK.
Anaesthetist fees only — the surgical, hospital and theatre fees are separate. Ranges vary by case length, complexity and technique.
In short
A consultant anaesthetist for a short day-case: £450–£900, on top of the surgical fee.
| Service | Indicative range | Typical duration | Recovery |
|---|---|---|---|
| Anaesthetist fee — short day-case (≤1 hour) | £450–£900 | Under 1 hour | Same day |
| Anaesthetist fee — medium case (1–2 hours) | £700–£1,400 | 1–2 hours | Same day |
| Anaesthetist fee — major case (2–4 hours) | £1,200–£2,400 | 2–4 hours | 1–3 nights |
| TIVA (propofol ± remifentanil) supplement | £150–£350 | Per case | Same day |
| Regional block or spinal adjunct | £250–£600 | 15–30 min | Same day |
| Pre-assessment consultation only | £180–£350 | 30 min | Same visit |
Prices vary by anaesthetist, by hospital, by case length and by technique — TIVA and combined regional adjuncts add to the fee. Insurers usually cover the anaesthetist for medically indicated surgery.
The problem
The anaesthetist is the doctor you meet last, and worry about first.
Most patients never meet their anaesthetist until they are on the trolley. That is the wrong order. A proper pre-assessment, a named consultant and a technique chosen for you — not for the list — changes the whole experience.
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Worried about waking up?
Awareness is very rare — about 1 in 19,000 with modern monitoring. We explain what monitors are used and why.
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Bad experience last time?
Post-op nausea, sore throat or shivering are common and largely preventable — the plan is built around what went wrong before.
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Older, obese, OSA or family MH?
These need a considered plan — lighter agents, TIVA, regional adjuncts — not a standard list slot.
The journey
From pre-assessment to recovery — what happens, in order.
One consultant anaesthetist named in advance — the same clinician who assesses you, gives the anaesthetic and reviews you after.
Phase 1 · Before your anaesthetic
Pre-assessment and preparation
Phase 2 · On the day
A few hours in theatre and recovery
Phase 3 · After
Recovery and ward, ERAS
- 01
Before
You tell us what surgery is planned
A short, confidential form. The procedure, your medical history, medications and any past problems with anaesthetics.
- 02
Before
Pre-assessment clinic
A consultant-led review — history, airway examination (Mallampati, mouth opening, neck), bloods, ECG if indicated, ASA grade assigned, and a plan agreed.
- 03
Before
Fasting and medication instructions
Solids stop 6 hours before, breast milk 4 hours, clear fluids up to 1 hour. Anticoagulants, insulin and GLP-1 agonists reviewed in writing.
- 04
On the day
Arrival and WHO checklist
Sign-in, limb marked if relevant, cannula sited, monitoring on — SpO2, ECG, blood pressure, capnograph, temperature.
- 05
On the day
Induction and airway
IV induction agent (usually propofol) over about 30 seconds, then an LMA or a breathing tube (ETT), ventilator, and maintenance with volatile or TIVA.
- 06
On the day
Emergence and recovery
Muscle relaxant reversed, tube out once you are breathing for yourself, transfer to recovery (PACU) — warm blankets, anti-emetics, pain plan already running.
- 07
After
Ward and discharge
30–60 minutes in recovery, then back to the ward or day-case unit. ERAS principles: early hydration, mobilise, opioid step-down, home when fit.
Typical end-to-end: 1–2 weeks from pre-assessment to theatre. Recovery in PACU: 30–60 minutes.
When it is used
When a general anaesthetic is the right choice.
The situations where a GA is standard, and the one situation that means optimisation first, not a same-week list.
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Longer or more painful surgery
Abdominal, orthopaedic, complex ENT and most laparoscopic work needs a full GA rather than sedation or a block.
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Airway or head-and-neck procedures
Where the surgeon needs a still, protected airway — GA with an endotracheal tube gives that.
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When you would rather not be aware
Some procedures can be done under sedation or block, but you would rather be fully asleep — a valid, considered choice.
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Children and anxious adults
Where staying still is not realistic, GA is often safer and kinder than repeated attempts under local.
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Failed or unsuitable regional
A spinal or block that has not worked, or is contraindicated by anticoagulation or spinal pathology.
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Elective cosmetic and dental work
Long cosmetic cases and full-mouth dental rehabilitation are routinely done under GA in a proper theatre.
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ERAS-planned major surgery
Colorectal, hepatobiliary and major joint work — GA combined with regional anaesthesia and enhanced recovery.
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Red flag: unstable cardiac or airway
Severe uncontrolled heart disease, unstable angina or an unassessed difficult airway need optimisation first — not a same-week list.
Technique options
A general anaesthetic is not one thing.
What each technique actually involves — and which fits which case. Discussed with you before the day.
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Volatile maintenance GA
IV induction with propofol, then sevoflurane, desflurane or isoflurane through a breathing circuit — the classic technique for most surgery.
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TIVA (total intravenous anaesthesia)
Propofol ± remifentanil by infusion throughout, no volatile agent. Clearer heads, less nausea, and the technique of choice if malignant hyperthermia is a concern.
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GA with LMA
A laryngeal mask sits above the vocal cords — used for shorter, lower-risk cases where a full breathing tube is not needed.
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GA with endotracheal tube
A tube through the vocal cords, protecting the airway — used for abdominal, laparoscopic, head-and-neck and longer cases.
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GA + regional block
A GA combined with a nerve block, spinal or TAP block — less opioid, better waking, and a smoother first 24 hours.
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GA + epidural
A GA with an epidural catheter for major open surgery — pain relief that continues into the ward for a day or two.
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Rapid sequence induction (RSI)
A faster induction for patients at risk of aspiration — emergency surgery, reflux, pregnancy — with cricoid pressure and quick tube placement.
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Pre-assessment only
A consultant anaesthetist review before you decide — sensible if you are borderline for fitness or want a second opinion on the plan.
Our vetted UK network
A small panel of consultant anaesthetists, we picked them.
Consultant anaesthetists across central, north, west and south London and the home counties. Not listed publicly — introductions are made privately, once we understand the case.
Selection criteria
How we choose every anaesthetist in our network.
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Consultant anaesthetists on the GMC specialist register, FRCA-qualified
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Fellowship of the Royal College of Anaesthetists (FRCA) with day-case and complex-case experience
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CQC-regulated theatres with full monitoring and PACU cover
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Second-opinion anaesthetist available if you want independent review
Safety and risks
The real risks of a general anaesthetic — honestly.
Framed the way the Royal College of Anaesthetists frames them for patients — common, uncommon, rare, very rare — plus the special situations that need extra planning.
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Common — sore throat and nausea
A sore throat from the tube or LMA affects up to 4 in 10. Post-operative nausea is common and prevented with dexamethasone and ondansetron on induction.
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Common — shivering and drowsiness
Shivering, mild confusion and drowsiness in the first few hours are expected. Warming blankets (Bair Hugger) reduce shivering; simple time fixes the rest.
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Uncommon — chipped teeth or minor allergy
Between 1 in 100 and 1 in 1,000: a chipped or damaged tooth from intubation, urinary retention, prolonged nausea, or a minor drug allergy.
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Rare — serious allergy or nerve injury
Between 1 in 1,000 and 1 in 10,000: anaphylaxis, a positioning nerve injury (usually recovers over weeks), a corneal abrasion, or a difficult intubation.
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Very rare — awareness or worse
Awareness under GA runs at around 1 in 19,000 with modern monitoring (NAP5). Permanent brain injury or death directly attributable to GA in a fit adult is around 1 in 200,000.
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Elderly — post-op delirium
Post-operative delirium affects 10–20% of older patients, and a longer cognitive dysfunction can follow. The anaesthetist plans around this — lighter agents, regional adjuncts, less opioid.
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Obesity and OSA
Airway management, VTE and emergence take more planning. If you have obstructive sleep apnoea, bring your CPAP machine — you will use it in recovery.
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Malignant hyperthermia
A rare inherited reaction to volatile agents. If it runs in the family, the anaesthetist uses a TIVA technique and the theatre is prepared with dantrolene.
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Red flags after discharge
Persistent vomiting, severe pain not controlled by prescribed painkillers, calf swelling, breathing difficulty or a fever above 38 °C — call the clinic or attend A&E the same day.
Reading your anaesthetic chart
Your anaesthetic record in four parts. Read the last one first.
Whichever technique was used, the record the anaesthetist writes keeps to the same shape.
A quiet reminder
Anaesthetic language is precise and can read coldly — we translate it for you.
If you would like us to talk you through the chart before your review, just ask.
- 01 Header
ASA grade, procedure and technique
Your ASA fitness grade, the procedure done, and whether you had a volatile GA, TIVA, or a combined GA-plus-regional technique.
- 02 Technique
Airway, drugs and monitoring
Whether an LMA or endotracheal tube was used, the induction and maintenance drugs, muscle relaxant and its reversal, and the monitoring in place.
- 03 Findings
Intra-operative events and blood loss
Any noteworthy events — a difficult intubation, a drop in blood pressure, arrhythmia — plus estimated blood loss and fluid balance.
- 04 Impression
Recovery plan and post-op instructions
Read this first: pain plan (PCA, patches, paracetamol, NSAID), anti-emetic plan, VTE prophylaxis, and when you can safely drive, drink alcohol or return to work.
Recognised by major UK insurers
Anaesthetist fees are usually covered when the underlying surgery is medically indicated. Cosmetic and self-funded cases are self-pay. We confirm cover before booking.
Frequently asked
Everything patients ask about being put to sleep.
Quick, honest answers on fasting, awareness, technique choice and the real risks.
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What actually happens when I am “put to sleep”?
A cannula goes in the back of your hand, monitoring is attached, and an IV induction drug (usually propofol) is given slowly. You feel a cool sensation up the arm and lose consciousness in about 30 seconds. An airway device — either an LMA or a breathing tube — is placed, and the anaesthetist keeps you asleep with a gas (sevoflurane) or a continuous propofol infusion (TIVA) until surgery ends.
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How long do I have to fast before a general anaesthetic?
Current AAGBI guidance: no solid food for 6 hours, no breast milk for 4 hours, and clear fluids allowed up to 1 hour before induction. ERAS pathways add a carbohydrate loading drink up to 2 hours before. The old “nil by mouth from midnight” rule is out of date — clear fluids close to the case reduce nausea and thirst.
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Should I stop my medications before a GA?
Most regular medications are continued with a sip of water. Anticoagulants (warfarin, DOACs), some diabetes drugs and — since 2023 — GLP-1 agonists like semaglutide need specific timing. The pre-assessment gives you a written list. Never stop a heart or blood-pressure drug without being told to.
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Will I wake up during the operation?
Awareness under a general anaesthetic is very rare — around 1 in 19,000 cases with modern monitoring, per the RCoA NAP5 audit. Depth-of-anaesthesia monitors are used when the risk is higher (paralysed patients, TIVA, obstetric emergencies).
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What is the difference between volatile GA and TIVA?
Volatile GA uses a vapour (sevoflurane, desflurane, isoflurane) breathed through the circuit to keep you asleep. TIVA — total intravenous anaesthesia — uses a continuous propofol infusion (often with remifentanil) instead. TIVA tends to give less post-operative nausea and a clearer head; it is also the technique used if malignant hyperthermia is a concern.
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Is a regional block or spinal better than a GA?
Not universally — they are different tools. A spinal or block avoids the systemic effects of GA and gives excellent pain relief, but you are awake or lightly sedated. A combined GA-plus-block is often the best of both: you are asleep for the surgery but wake with the pain already controlled.
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What are the real risks of a general anaesthetic in a healthy adult?
The RCoA patient information puts it plainly. Common (>1 in 100): sore throat, nausea, drowsiness, shivering. Uncommon (1 in 100–1,000): damaged teeth, urinary retention. Rare (1 in 1,000–10,000): serious allergy, nerve injury from positioning. Very rare (<1 in 100,000): permanent brain injury or death directly from the GA in a fit adult, roughly 1 in 200,000.
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When can I drive, drink alcohol or make important decisions after a GA?
Not for 24 hours. Judgement, reflexes and coordination are impaired even after you feel back to normal, and the residual drugs interact with alcohol. Do not sign contracts, drive, operate machinery or care for a child alone for a full day after discharge — bring someone to collect you and stay with you overnight.
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