Informed consent is the process of communication between a patient and the anesthesia provider that results in the patient’s authorization or agreement to undergo anesthesia. For both ethical and legal reasons, patients must be given enough information to be fully informed before deciding to assume the risks associated with anesthesia. For pediatric patients, their parents or legal guardians must sign for consent.

All consents will need to be signed prior to your procedure. We will recommend the type of anesthesia best suited for your procedure, your medical condition, and your surgeon’s requirements. Your preferences will also be considered.

Anesthesia is generally safe. If you have chronic health issues, there may be additional anesthesia risk. Not all the risks can be covered by the provided consent form. Please ask your anesthesia provider any questions that you may have and be sure to express any concerns.


NPO is a medical abbreviation for “nothing by mouth”. It is very important to adhere to the fasting guidelines established by the American Society of Anesthesiologists. If your stomach is not empty, you may vomit and aspirate stomach contents into your lungs. For this reason, we recommend to not consume food after midnight. However, if the surgery is late in the day, you may eat as indicated in the table below. Additionally, please avoid breath mints and chewing gum. If criteria is not followed, your procedure may be postponed or cancelled.


Administering general anesthesia in an office setting is very safe. Apex Anesthesia Services uses various advanced technologies, equipment, medications and supplies to provide a safe and effective treatment. Apex Anesthesia Services teams are highly trained in emergency care and post anesthesia monitoring. Prior to the day of procedure, your medical history is reviewed and any necessary medical consultations are obtained. On the day of surgery, you will meet and have a final assessment by your anesthesia provider. During the procedure, your anesthesia provider remains with you throughout the procedure and carefully monitors your heart rate, electrocardiogram, blood pressure and oxygen delivery. Your airway may be secured with a breathing tube and necessary medications will be administered via an intravenous line. It is extremely important for you to provide us with accurate health information prior to your procedure so the anesthesia provider can tailor your anesthetic accordingly to minimize any complications. It is also crucial to follow all pre-operative instructions carefully.


Our office will contact you to confirm your procedure and go over the pre-operative instructions. If we are unable to reach you, please call the office and confirm your appointment.

Food & Drink

We recommend that you not consume food after midnight. However, if the surgery is late in the day, you may eat as indicated in the NPO guidelines table (Please refer to the NPO instructions). Additionally, we recommend that you do not smoke, chew tobacco or consume alcohol for at least 24 hours prior to your surgery.


  • Prescription medications should be taken as scheduled with clear liquids (water or apple juice) up to 2 hours before your procedure, unless previously directed by your doctor. You may take your usual blood pressure, heart, acid reflux, and/or seizure medicine on the morning of surgery with a sip of water.
  • If you are currently taking a prescription blood thinner (Coumadin, Plavix, etc.) on a regular basis, please contact your prescribing doctor for further instructions.
  • Do not take any diabetic medicine the day of surgery. However, please make sure to bring your diabetic medication and your blood sugar measuring device with you. Please provide us with an accurate list of your daily medications. If you have any questions on which medications you may or may not take the day of your procedure, please contact our office at (509) 764-5399.
  • If you experience any health changes, such as an elevated temperature, cough or other health-related problems, please notify our office immediately.


Patients are not permitted to drive or leave office unattended after the procedure. It is necessary to make arrangements for a responsible adult or caregiver to drive you home and stay with you for 24 hours following surgery. Without these arrangements, your surgery will be canceled. A parent or legal guardian must remain on premises while their child is having treatment.


  • You may brush your teeth prior to surgery, but remember not to swallow liquids after midnight. Contact lenses and eye make-up must be removed. Jewelry and body piercing should not be worn on the day of surgery. Please leave all valuables at home.
  • Please wear comfortable, loose clothing. For children, please bring extra undergarment and/or diapers. You may bring their favorite toy or blanket as well.
  • You will be asked to arrive early to confirm the availability of all necessary information. The anesthesia provider will do the preoperative assessment and will go over the anesthesia consent. Females of childbearing age will be required to provide a urine sample for the pregnancy test. Your surgeon will confirm with you the treatment and will request your permission to perform the scheduled procedure.
  • A parent or legal guardian must accompany any minor or impaired adult the day of surgery and must remain at the office throughout the patient’s stay.


After your procedure is completed, you will be cared for in the recovery area, where you will be closely monitored by our experienced staff until you are deemed ready to go home. At the time of discharge, we will give your escort specific instructions regarding your home care. All instructions related to your surgical treatment will be given by your surgeon or his/her staff.

  • Due to the use of anesthesia and/or narcotics, you may experience sleepiness, dizziness, or nausea. These are normal side effects, which may continue for 12-24 hours. Remember to drink plenty of liquids upon your return home. If teeth were extracted, do not use a straw. Please follow a soft food diet.
  • Due to the symptoms, you may experience after the anesthesia, please do not do any of the following activities for at least 24 hours after the discharge, or longer if you are taking pain medications:
    • Drive and operate equipment or machinery
    • Sign important papers
    • Make significant decisions
    • Drink alcoholic beverages
  • Muscle aches, a sore throat or a low-grade fever may occur following the anesthesia. These symptoms are very common and usually disappear within 24 hours. A common post-operative complication is a nosebleed, which is the side effect from the intubation – a breathing tube placement. The nosebleed usually stops easily by pinching the tip of the nose for at least 10-15 minute.

If you experience any problems or difficulties following your procedure, please call Apex Anesthesia at (509) 764-5399. However, if it is after regular business hours, please contact the on-call doctor at (509) 995-7746.


Seek advice in case of:

  • Vomiting repeatedly
  • Temperature over 101˙ F

If you have any other concerns, please contact our office at: (509) 764-5399 or Dr. Pester at (509) 995-7746

If you experience a life threatening emergency, please call 911 or go to a nearest Emergency Room.


At Apex Anesthesia, we participate in most major insurance plans. However, we suggest that you verify your eligibility for services with your insurance company.

All financial arrangements for surgical procedures will be handled by your surgeon’s office. Charges for the anesthesia services will be separately processed by Apex.

We offer Care Credit and accept all major credit cards. We kindly request all anesthesia payments to be made prior to your procedure.


Contact us at (509) 764-5399 or email us at [email protected]

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