Impact of anaesthesia mode on evaluation of LEEP specimen dimensions

Mercuzot, Antonin; Chevreau, Julien; Sevestre, Henri; Muszynski, Charles; Arbyn, Marc; Sergent, F.; Gondry, J.

doi:10.1016/j.jogoh.2016.12.006

Cited by 6 publications

(9 citation statements)

References 14 publications

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“…There was no difference in the rate of positive cervical margins compared with conization under GA. However, follow-up colposcopy outcome and the need for repeated conization were not examined in that study 9 . In a prospective randomized trial that compared conization under both modes of anesthesia, Rezniczek et al 6 reported more favorable overall outcomes when conization was done under LA.…”

Section: Discussionmentioning

confidence: 99%

“…However, follow-up colposcopy outcome and the need for repeated conization were not examined in that study. 9 In a prospective randomized trial that compared conization under both modes of anesthesia, Rezniczek et al 6 reported more favorable overall outcomes when conization was done under LA. The cone dimensions were smaller in height, volume, and mass; the resection margin status was not different between the GA and LA groups; and patient satisfaction with LA was higher compared with GA.…”

Section: Discussionmentioning

confidence: 99%

“…6,7 However, available data on comparable procedure outcomes, including rates of positive surgical margins and, more importantly, the need for repeat conization are sparse and inconsistent. 6,8,9 The objective of this study was to contribute to these data by comparing the rate of positive specimen margins and postconization follow-up findings, including the need for repeat conization, between women who underwent LEEP under GA versus LA.…”

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confidence: 99%

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Recurrent Dysplasia After a Loop Electrosurgical Excision Procedure: Local Versus General Anesthesia

Tzur

Berkovitz-Shperling

Laskov

et al. 2022

J Low Genit Tract Dis

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Objective: This study aimed to compare the rates of positive specimen margins and postconization recurrent dysplasia between loop electrosurgical excision procedures (LEEPs) performed under general anesthesia (GA) and LEEP under local anesthesia (LA).Methods: This retrospective cohort study included all consecutive women who underwent LEEP between 2011 and 2019. Collected data included demographics, LEEP indication, cone dimensions, and margin involvement as well as recurrence rate. Women who had undergone previous conization, cold-knife conization, or those who were lost to follow-up during the first 2 years after the procedure were excluded.Results: Overall, 71 women who underwent LEEP under GA and 75 women under LA were included. Demographic characteristics were similar between the groups, as were the rates of preceding abnormal cytology and high-grade dysplasia before conization. Although cone depth and volume were higher for LEEP specimens done under GA compared with LA, the rate of positive specimen margins was comparable both for the endocervical margin (16/71 [22.5%] vs 16/75 [21.3%], respectively; p = .861) and the ectocervical margin (14/71 [19.7%] vs 11/75 [14.7%], respectively; p = .418). During the first 2 years after conization, the rates of high-grade dysplasia (cervical intraepithelial neoplasia ≥ 2) in repeat biopsy and the need for repeat conization were also not significantly different between the GA and LA groups (4.2% vs 1.3%, p = .356; 7.0% vs 9.3%, p = .614, respectively).Conclusions: Anesthesia mode does not seem to affect the rate of positive LEEP margins and the need for repeat conization. Our study findings suggest that LA should be preferred instead of GA in LEEP.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Recurrent Dysplasia After a Loop Electrosurgical Excision Procedure: Local Versus General Anesthesia

Tzur

Berkovitz-Shperling

Laskov

et al. 2022

J Low Genit Tract Dis

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“…Cervical conization can be performed under various anesthesia types, such as local anesthesia, local/regional block anesthesia, spinal anesthesia or general anesthesia. Among them, general anesthesia is preferred by anesthesiologists and day case surgeons 4 as it provides a superior hypnotic effect without affecting postoperative ambulation. Besides, it is known that the cone depth and volume are higher for loop electrosurgical excision procedure specimens conducted under general anesthesia than local anesthesia.…”

Section: Introductionmentioning

confidence: 99%

“…Besides, it is known that the cone depth and volume are higher for loop electrosurgical excision procedure specimens conducted under general anesthesia than local anesthesia. 4 , 5 Cervical traction and excessive nervousness may cause vagal reflex, further worsening the decrease in venous return to the heart. Reports of cardiac arrest during cervical conization have also been documented.…”

Section: Introductionmentioning

confidence: 99%

Cardiopulmonary Adverse Events of Remimazolam versus Propofol During Cervical Conization: A Randomized Controlled Trial

Wang¹,

Wang²,

Ma³

et al. 2023

DDDT

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Purpose This study aimed to compare the cardiopulmonary safety of remimazolam and propofol in patients undergoing cervical conization. Methods This was a single-blind, parallel, randomized controlled study. A total of 204 patients scheduled for day surgery of cold knife cervical conization received either remimazolam-alfentanil anesthesia (remimazolam group) or propofol-alfentanil anesthesia (propofol group). The primary outcome was the incidence of intraoperative cardiopulmonary adverse events (a composite outcome of hypotension, bradycardia and hypoxemia). The occurrence of hypotension, bradycardia, hypoxemia and the degree of body movement were secondary outcomes, as well as the moment at which consciousness was lost, the interval between the end of anesthesia and the operating room’s release of the patient, and the overall dosage of alfentanil administered during the procedure. Results The incidence of intraoperative cardiopulmonary adverse events was 45 (44.1%) in the remimazolam group and 72 (70.6%) in the propofol group (absolute risk difference [95% CI], −26.47% [−39.55% to −13.39%]; odds ratio (OR) [95% CI], 0.43 [0.28 to 0.65]; P < 0.001). The remimazolam group showed lower incidences of hypotension and hypoxemia compared to the propofol group ( P = 0.01 for both). No significant differences were observed in the overall alfentanil dosages administered, bradycardia, bodily movement, or time to losing consciousness between the two groups. Conclusion In patients who underwent cold knife cervical conization, remimazolam-alfentanil anesthesia was associated with a reduced incidence of intraoperative cardiopulmonary adverse events compared with propofol-alfentanil anesthesia.

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Laryngeal mask general anaesthesia versus spinal anaesthesia for promoting early recovery of cervical conisation: A randomised, controlled clinical study

Fang¹,

Chen²,

Zhang³

et al. 2023

Heliyon

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Impact of anaesthesia mode on evaluation of LEEP specimen dimensions

Cited by 6 publications

References 14 publications

Recurrent Dysplasia After a Loop Electrosurgical Excision Procedure: Local Versus General Anesthesia

Recurrent Dysplasia After a Loop Electrosurgical Excision Procedure: Local Versus General Anesthesia

Cardiopulmonary Adverse Events of Remimazolam versus Propofol During Cervical Conization: A Randomized Controlled Trial

Laryngeal mask general anaesthesia versus spinal anaesthesia for promoting early recovery of cervical conisation: A randomised, controlled clinical study

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