Planning a procedure that requires an anaesthetic? As a Specialist Anaesthetist and Pain Physician, Dr Meena Mittal provides perioperative anaesthesia care across several Victorian hospitals. This page is designed to give you information on your anaesthetist, the types of anaesthesia available, the billing and fees structure, and answers to some general questions about your anaesthesia.

About Dr Mittal’s anaesthesia practice

Dr Mittal completed a Bachelor of Medicine and Surgery at the University of Melbourne in 2003 (MBBS, with Honours). She then completed a Fellowship in Anaesthesia at The Alfred Hospital in 2013 and a Fellowship in Pain Medicine — also at The Alfred — in 2014, again with Honours. She holds FANZCA (Fellow of the Australian and New Zealand College of Anaesthetists) and FFPMANZCA (Fellow of the Faculty of Pain Medicine, ANZCA) and is a graduate of the Australian Institute of Company Directors (GAICD). She currently serves as Vice-President and Director of the Neuromodulation Society of Australia and New Zealand.

In her anaesthesia practice, Dr Mittal provides general anaesthesia, regional and neuraxial anaesthesia, and sedation for procedures such as general surgery, orthopaedics, gynaecology, interventional radiology, endoscopy, and eye surgery. She has a particular interest in the perioperative care of patients with chronic pain — a group whose anaesthetic needs differ meaningfully from the general theatre population, and for whom a carefully chosen anaesthetic technique and post-operative analgesia plan can shape their pain trajectory for months afterwards. That interest is a direct extension of the work she does at Persistent Pain Solutions.

Her approach — whether she is seeing you in the rooms for a pain consultation or meeting you in the holding bay on the morning of your procedure — is the same. She takes the time to understand what matters to you, explains what is about to happen and why, answers your questions, and makes the experience as safe and as humane as it can be.

What is anaesthesia? What does an anaesthetist do?

Anaesthesia is the use of medication to produce a reversible, controlled loss of sensation so that surgery, a procedure, or an investigation can be carried out safely and without pain. It is administered and continuously monitored by a Specialist Anaesthetist — a medical doctor with at least five years of additional postgraduate training after medical school — who stays with you for the entire duration of your case.

The anaesthetist’s role is rarely a single injection. Before your procedure, your anaesthetist reviews your medical history, your medications, allergies, past anaesthetic experience, your airway, and the specifics of the surgery or investigation you are having and determines the best and safest anaesthetic for you. During the case, they titrate anaesthetic medications in real time, manage your breathing and circulation, control pain, and respond to anything unexpected. Afterwards, they oversee your wake-up in the recovery unit and plan your post-operative analgesia so that you are comfortable when you leave theatre.

Types of anaesthesia

Anaesthesia is not one technique but a family of techniques, selected and often combined based on the procedure you are having, your medical history, and your preferences. The most common types include but are not limited to:

• General anaesthesia. A state of carefully controlled unconsciousness, delivered through an intravenous induction drug and then maintained with either inhaled gas or a continuous infusion. Your anaesthetist manages your breathing — usually through an airway device — and monitors your vital signs throughout. General anaesthesia is used for most major and many minor procedures where it would be uncomfortable, unsafe, or impractical for you to be awake.
• Sedation (monitored anaesthesia care). Medication that produces drowsiness, relaxation, and partial or full amnesia for the procedure while you continue to breathe on your own. Sedation ranges from light, in which you may respond to conversation, to deep, in which you are unaware but not fully unconscious. It is commonly used for short investigations such as gastroscopy and colonoscopy, some cosmetic procedures, and many interventional pain procedures.
• Regional anaesthesia. A nerve block — a local anaesthetic injection placed around a specific nerve or group of nerves — that numbs a defined part of the body, such as an arm, a leg, or a section of the chest or abdomen. Regional anaesthesia can be used as the sole anaesthetic, usually with sedation for comfort, or combined with a general anaesthetic to reduce pain in the hours and days afterwards.
• Neuraxial anaesthesia (spinal and epidural). Local anaesthetic delivered into or around the spinal canal, numbing the lower half of the body. A spinal anaesthetic is a single injection that works quickly and wears off within a few hours. An epidural uses a fine catheter that can be topped up or run continuously — typically for hours to days — as in labour analgesia or major abdominal surgery.
• Local anaesthesia. An injection of local anaesthetic into the skin and surrounding tissue for small procedures such as skin excisions, dental work, and some minor interventional procedures. Local anaesthesia is usually managed by the proceduralist rather than the anaesthetist, though your anaesthetist may still be involved if you need accompanying sedation or if your medical history warrants specialist anaesthetic input.
• Combined techniques. Many cases use a layered approach — for example, a general anaesthetic for the procedure itself combined with a regional block that keeps you pain-free for the first 24 hours after surgery. Combinations are chosen to give you the best comfort and safety profile for the procedure you are having.

The right technique for your case is a shared decision. Before the day of surgery — or in the pre-operative area, if you have not met beforehand — Dr Mittal will go through the options, the risks and benefits of each, and her recommendation. If you have a clear preference, let her know; where it is safe to accommodate it, she will.

Safety in anaesthesia

Anaesthesia in Australia is among the safest interventions in modern medicine. That safety is not incidental. It is the product of specialist training, continuous intraoperative monitoring, rigorous standards set by ANZCA, and a culture of preparation for the rare event.

The risks and complications of anaesthesia depend on the type of surgery or procedure you are having, your general health, and the type of anaesthesia being administered. Common risks include nausea, vomiting, drowsiness, and sore throat. The specific risks relevant to you and to your surgery will be discussed by the anaesthetist on the day.

To minimise the risk of anaesthesia and to ensure your safety, we request that you:

• Discuss any previous issues with anaesthesia — such as reactions to anaesthesia or airway difficulties — with the surgeon and anaesthetist.
• Inform the surgeon and anaesthetist of any health conditions in advance.
• Inform the surgeon and anaesthetist of your medications and allergies in advance.
• Stop herbal medications for two weeks prior to the surgery or procedure.
• Find out which medications to continue and which to cease prior to surgery, from the surgeon or the anaesthetist.
• Inform the surgeon or anaesthetist if you are unwell in the few days before surgery. In that instance, you will be assessed and a decision to continue or postpone surgery will be made.
• Where possible, improve your general fitness levels and maintain a healthy weight.
• Use your CPAP machine diligently if you have obstructive sleep apnoea.
• Stop smoking at least six weeks before surgery, to minimise the risk of post-operative complications such as respiratory infections.
• Reduce your alcohol consumption in the lead-up to surgery.
• Ensure that any symptoms of gastro-oesophageal reflux are well controlled before surgery.
• Follow the specific fasting instructions accurately, as discussed with you before surgery. This is to minimise the risk of aspiration during anaesthesia.

Billing and fees

Billing information

Specialist anaesthesia in Australia is billed separately from the surgeon’s fee and from the hospital’s accommodation and theatre fees. That structure can come as a surprise, particularly for patients who have not had a major procedure before, so the sections below set out exactly how Dr Mittal’s anaesthesia billing works.

Informed Financial Consent

Before your procedure — and always before you incur any out-of-pocket expense — you will receive a written quote with your likely total estimated fee or out-of-pocket cost. This is your Informed Financial Consent, and you will be asked to acknowledge it in writing before the day of surgery. If your procedure is clinically urgent and there is no time to provide a written quote in advance, you will receive one as soon as is practicable, and your out-of-pocket cost will not exceed the quoted range.

If you have private health insurance

Please note that different health funds have different rebate schedules. We will invoice your health fund for the total rebate (including Medicare), and you will be provided with a written quote for the estimated out-of-pocket cost (or co-payment) with the standard itemised numbers. This method allows you to receive the highest level of rebate, which is usually above the Medicare Benefits Schedule.

There are some health funds that do not allow a co-payment, and in that instance we will issue you with an account for the total fee, payable prior to the procedure. You can then claim the rebate from Medicare and your health fund if eligible. This type of payment means that the rebate is 100% of the Medicare Benefits Schedule.

If you have Medicare only (that is, no private health insurance)

Medicare provides a rebate for medically necessary anaesthesia services. You will be provided with a written quote informing you of the estimated total fee, itemised before the procedure. You may then present to Medicare after the procedure to seek your Medicare rebate.

Department of Veterans’ Affairs and Defence Health

We accept DVA Gold and DVA White Card patients for covered conditions, with no out-of-pocket costs for eligible procedures. Your referrer and our rooms will confirm your entitlements before booking.

WorkCover, TAC, self-funded, and third-party insurers

WorkCover, TAC and self-funded patients are accepted on a pre-approved basis. There will be no out-of-pocket costs for approved procedures.

How payment is taken

Anaesthesia invoices are issued prior to your procedure and emailed to you. Payment can be made by credit or debit card using the link in your email, which opens an individualised, secure patient portal. Please read this information thoroughly; once you have consented, the payment options will appear. In most cases, rebates from Medicare and your health fund can be claimed directly by our rooms, with only the out-of-pocket amount payable by you. We require pre-payment for all fees (total or out-of-pocket) prior to the procedure or surgery.

Billing queries

If anything on your quote or invoice is unclear, please do not hesitate to call our rooms and ask.

Anaesthesia FAQs

These questions relate specifically to anaesthesia services. For general questions about Persistent Pain Solutions — our consulting rooms, pain medicine referrals, interventional pain procedures, and fees for pain consultations — please see our main FAQ.

Do I need a referral to have an anaesthetic?
You do not refer directly to an anaesthetist the way you would to a pain physician. Your surgeon or proceduralist books the theatre, and Dr Mittal is allocated — or specifically requested — as the anaesthetist for your case.

When will I meet my anaesthetist?
For elective cases, you will usually either receive a pre-operative phone call in the days before your procedure or meet your anaesthetist in the holding bay on the morning of surgery. For higher-risk cases, an appointment may be arranged beforehand. You will always have the opportunity to ask questions and give consent before anything begins.

How long do I need to fast before my anaesthetic?
Standard adult fasting guidance is no food for six hours and clear fluids up to two hours before your procedure. Chewing gum, mints, sweets, and milk all count as food. Your hospital will send you specific fasting instructions when your booking is confirmed — follow those, as they may differ slightly from the general rule. If you take a weight-loss medication — such as semaglutide or tirzepatide (for example, Ozempic, Wegovy, or Mounjaro) — the fasting instructions are different (an extended fast), and the hospital will advise you a few days before the procedure.

Should I take my usual medications on the morning of my procedure?
Some medications are taken as normal, some are withheld, and some require a temporary change — particularly blood thinners, diabetes medications, and some blood pressure medications. The hospital will review your medications list and then give you specific instructions based on Dr Mittal’s requirements. If you have not received instructions, or if you have any concerns about a specific medication, please call our rooms.

Will I feel anything during my anaesthetic?
Under a properly conducted general anaesthetic, you will not feel pain, have no memory of the procedure, and have no awareness of time passing. Awareness under general anaesthesia — being conscious during the case — is extremely rare when modern monitoring is used. Under sedation, you may retain some awareness depending on the level of sedation.

Will I feel sick or groggy when I wake up?
Modern anaesthesia is designed to minimise post-operative nausea, vomiting, and grogginess — and for most patients, recovery is smooth. If you have a history of post-operative nausea, let Dr Mittal know before the procedure; there are several preventive strategies available. You may feel tired for the rest of the day and should not drive, operate machinery, make important decisions, or care for young children unsupervised for 24 hours.

What are the risks of anaesthesia?
Most healthy patients experience no significant complications. Common, minor, and temporary side effects include nausea, sore throat, shivering, and drowsiness. Less common risks include dental damage from airway devices, allergic reactions, and, very rarely, more serious events involving the heart, lungs, or nervous system. We will discuss the risks that are specifically relevant to your procedure and your health during your consent discussion.

Can I choose my type of anaesthetic?
Often, yes — especially where there is more than one technique that would be safe and effective for the procedure you are having. Let Dr Mittal know what you would prefer, and why, and she will discuss whether it is appropriate in your case. Where a specific technique is not suitable, the reasons for the alternative are explained in detail.

What if I am anxious about the anaesthetic?
Pre-operative anxiety is common and understandable. Please mention it — during our pre-operative contact, or on the day. Several medications and non-pharmacological strategies can help, and for many patients, simply being told clearly what to expect is enough to take the edge off.

Who looks after me when I wake up?
You will wake up in the post-anaesthesia care unit (recovery) under the supervision of specialist recovery nurses, with Dr Mittal available if any concerns arise. Once you are awake, comfortable, and stable, you will be transferred either to the day-surgery unit for discharge or to a ward for admission, depending on the procedure you have had.

When will I receive my anaesthesia bill?
You will receive your Informed Financial Consent quote, and the invoice, before your procedure. We require pre-payment before the procedure or surgery. If you have any questions about the invoice, please contact our rooms.

What if I need to cancel or reschedule my procedure?
Call our rooms as soon as you know. No fee generally applies to cancellations.

Contact

For anaesthesia bookings, quotes, Informed Financial Consent, or billing questions:

• Phone: (03) 9875 8226 — press the number for “Anaesthesia Services”.
• Email: [email protected]
• Fax: (03) 9012 4123
• Postal: Suite 201C, 521 Toorak Road, Toorak VIC 3142

Our rooms are attended Monday to Friday, 9am–5pm. Please allow at least 48 business hours for a reply to emailed queries. For clinical questions, please phone the rooms rather than email. If your concern is urgent, attend your nearest emergency department or call 000.

For surgical rooms: faxed or emailed referrals, operation booking forms, and pre-operative correspondence can be sent to the details above. For urgent or same-day theatre bookings, please call directly.