Despite extensive international experience with local anesthesia for laparoscopic tubal sterilization, this technique has been slow to gain acceptance in the United States. The purpose of this study was to compare local and general anesthesia for laparoscopic sterilization. The design of the study was a retrospective review of all laparoscopic sterilizations at San Francisco General Hospital performed over a 2-year period. Patients receiving local anesthesia were compared to patients receiving general anesthesia, and the mode of anesthesia was determined by patient preference. The main outcome measures were completion of planned procedure, patient satisfaction, and cost. We reviewed 209 cases, with 202 patients (97%) receiving the type of anesthesia initially requested. General anesthesia was employed in 81 cases (39%). The two groups were similar with respect to complications and postoperative disability. In both groups, 85% of the patients stated that the procedure met or exceeded their expectations. The average cost of each procedure was $1200 for local anesthesia and $3971 for general anesthesia. We conclude that local anesthesia is an effective and inexpensive alternative to general anesthesia for female sterilization. More widespread use of this technique could decrease significantly the costs of family planning programs nationwide.
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