Local anesthesia, used with or without mild sedation and analgesia, is preferable to general anesthesia. Local anesthesia with sedation and analgesia:
Sterilization under local anesthesia, with or without mild sedation and analgesia, can be done when a member of the surgical team has been trained to provide sedation and analgesia and the surgeon has been trained to provide local anesthesia. The surgical team should be trained to manage emergencies, and the facility should have the basic equipment and drugs to manage any emergencies.
Health care providers should explain to a woman ahead of time that being awake during the procedure is safer for her. During the procedure providers should talk with the woman and help to reassure her if needed.
The most common anesthetic used is lidocaine (lignocaine). Many different sedatives and analgesics may be used. The dosage of drugs must be adjusted to body weight. Oversedation should be avoided because it can reduce the client’s ability to stay conscious and could slow or stop her breathing.
In some cases, general anesthesia may be needed. See Medical Eligibility Criteria for Female Sterilization, for medical conditions needing special arrangements, which may include general anesthesia.