Mark Moore, MD
Tallahassee Anesthesiology, PA

The most common type of anesthesia used for LEEP Procedure today is a twilight sedation or intravenous sedation. That means the anesthesia medicines are given into the I.V. to make the patient very drowsy. Medications that are used include: sedatives like valium/diazepam or versed/midazolam, narcotic pain killers like morphine or demerol, non-narcotic pain killers like toradol/ketorolac, antinausea medicines like zofran or phenergan, and induction/sleep inducing medications like propofol or pentothal.

The sleep that occurs is sometimes like a "general anesthesia" but because it is intravenous, the patient emerges rapidly from the anesthesia and awakens quickly. Other times, the patient may be slightly awake but so comfortable as to not mind the LEEP procedure in progress. Occasionally, a "general anesthesia" is used, in which the patient is given intravenous medications to go to sleep, then a breathing tube is placed and anesthetic inhalational gases are used to keep the patient asleep. The awakening from this type of anesthesia can take longer because of the type of anesthesia gases. Rarely, a "regional anesthesia" might be used such as a spinal anesthesia or an epidural but this would be under very special circumstances–a patient who could not lay down or a patient who had such severe breathing problems, they could not undergo even a small amount of sedation.

LEEP AND LOOP

The LEEP procedure is one of the most common gynecologic procedures performed today.

You might ask: What does LEEP mean or stand for? The letters LEEP are an abbreviation for Loop Electrosurgical Excision Procedure. So then what does LOOP mean? The "LOOP" is a tiny thin cautery wire that is in the shape of a "loop". During the procedure, this wire gets red hot (from electricity) and the loop is swept across the affected tip of the cervix–effectively melting through the tissue and making a clean cut across its tip. This acts to cauterize the area to prevent bleeding. Sometimes there is some confusion between LEEP and LOOP and people use the words interchangeably, but they are not.

LEEP is performed to treat cervical/cervix dysplasia, or a abnormal change in the cells of the cervix (the cervix being the opening from the uterus to the vagina). The way that this abnormal dysplastic tissue on the cervix is discovered is with a PAP SMEAR. Other ways to treat this problem of dysplasia of the cervix include a "cold knife cone biopsy"–the surgeon uses a scalpel then sutures the area to prevent bleeding. The area can be "lasered" as in "laser ablation" or "frozen" (cryoablation). Lasers can be very accurate in removing the tissue and healing can be faster. Cryosurgery is often done in the office but is not effective for all types of dysplasia. Cryosurgery done in the office is done while the patient is awake. Your Gyn doctor can help you make the choice that’s right for you.