Anaesthetic choice in the colposcopy clinic: a retrospective analysis of routinely collected data.
OBJECTIVE
Current guidelines recommend that less than 20% of treatments in colposcopy clinics should be under general anaesthetic. The objective of this study was to increase the evidence base for guidelines by establishing the proportion of women receiving general anaesthesia for treatment, determining the predictors of and reasons recorded for general anaesthetic use.


METHODS
Retrospective analysis of routinely collected data.


METHODS
NHS Trust in the West Midlands.


METHODS
Colposcopy patients; January 2003 to March 2005.


METHODS
Logistic regression of factors associated with general anaesthetic choice.


METHODS
Proportion of women treated under general anaesthesia, factors associated with anaesthetic choice and reasons recorded for general anaesthetic use.


RESULTS
About 5.4% (204/3777) of new appointments for colposcopy received treatment under general anaesthetic. Of women requiring treatment, 20% (204/1003) received general anaesthetic. General anaesthetic was more likely to be used when the woman required loop excision (OR = 3.63, 95% CI 2.11-6.24) and less likely when directed biopsy was performed (OR = 0.11, 95% CI 0.01-0.80), when the patient appointment date was after introduction of new guidelines (OR = 0.37, 95% CI 0.24-0.56) or when the assessment visit was with a nonconsultant status doctor rather than nurse or consultant (OR = 0.70, 95% CI 0.50-0.97). General anaesthetic use varied between colposcopists ranging from 0 to 16.5% of new patients seen. Woman's choice was the most commonly specified reason for the use of general anaesthetic.


CONCLUSIONS
The proportion of colposcopy patients treated under general anaesthetic is 20%, within guideline limits. Substantial variation in general anaesthetic rates between colposcopists was observed, and further investigation is required to discover the reason for this.
Swancutt
D R
DR
Department of Primary Care and General Practice, University of Birmingham, Edgbaston, Birmingham, UK. d.r.swancutt@bham.ac.uk
Luesley
D M
DM
Eastaugh
J L
JL
Wilson
S
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000523:psychology / Q000706:statistics & numerical data; D000768:Anesthesia, General / Q000523:psychology / Q000706:statistics & numerical data*; D003127:Colposcopy / Q000523:psychology / Q000706:statistics & numerical data*; D003253:Consultants; D004739:England; D005260:Female; D006176:Gynecology / Q000706:statistics & numerical data; D006801:Humans; D008505:Medical Staff, Hospital / Q000706:statistics & numerical data; D008875:Middle Aged; D017060:Patient Satisfaction; D017410:Practice Guidelines as Topic; D011364:Professional Practice; D012017:Referral and Consultation; D019233:Retreatment / Q000523:psychology / Q000706:statistics & numerical data; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control / Q000523:psychology