Evaluation of the Satisfaction of Patients With Conization Under Local Anesthesia
Evaluation of the Satisfaction of Patients With Conization Under Local Anesthesia
In France, screening involves a routine test of papanicolaou in women aged 25 to 65 years. In
 the case of an abnormal Pap smear discovery, the diagnostic strategy is based in most cases
 in colscopy to allow cervical biopsies if necessary to obtain a histological diagnosis of
 high quality cervical intraepithelial neoplasia (CIN) (2- 3) which, if persistent, can cause
 cervical cancer. Their results, also in the case of the persistence of a low-level lesion or
 of a cyto-histological discordance, indicate conization. Conization is a procedure performed
 by resection of the diathermic grip, allowing a simple and fast gesture compatible with a
 load under local anesthesia. In order to simplify the overall cost of the patient, more and
 more conizations of Montpellier and Nimes take place under local anesthesia. .

 The main objective of our study is to evaluate the overall satisfaction of patients in the
 case of conisation under local anesthesia.

 The goal is to promote local anesthesia for the management of congested patients, which
 simplifies overall management, reduces cost and reduces complications associated with general
 anesthesia.
In France the screening is on the regular realization of a papanicolaou test (Pap smear or
 Pap test) in women aged 25 to 65 years. In the event of abnormal Pap smear discovery, the
 diagnostic strategy is based in most cases on colscopy to allow for cervical biopsies if
 necessary to obtain a histological diagnosis for cervical intraepithelial neoplasia (CIN )
 High grade (2-3) which, if persistent, may cause cervical cancer. Their findings, also in the
 case of persistence of low-grade lesion or cyto-histological discordance, indicate
 conization. The conization is an intervention realized by resection to the diathermic handle,
 allowing a simple and fast gesture compatible with a charge under local anesthesia. With a
 view to simplify the overall cost of the patient, more and more conizations of the
 Montpellier and Nimes are carried out under local anesthesia. A retrospective study found a
 good overall satisfaction of the patients with conisation under local anesthesia, it is
 interesting to continue this study by an evaluation of the patient's satisfaction in the
 prospective way, including validated rankings and to allow a risk assessment And the
 persistence of lesions.

 The main objective of our study is to evaluate the overall satisfaction of the patients in
 the case of conducting conization under local anesthesia. Secondary endpoints are
 preoperative anxiety assessed using the Visual Analog Scale (EVA) And the Amsterdam
 Preoperative Anxiety and Information Scale (APAIS) score, the occurrence of complications
 during the procedure, surgeon satisfaction, anesthesia tolerance using the Iowa Satisfaction
 with Anesthesia Scale score (ISAIS), and finally A follow-up at 3 months evaluation of
 secondary complications, margins of resections and persistence of lesions.

 This is a prospective multi-centric study (CHU Nîmes and Montpellier). During the day
 hospitalization, a questionnaire of satisfaction will be given to the patient. The primary
 outcome measure is the overall satisfaction of the patient assessed as a question. Secondary
 endpoints are preoperative anxiety assessed using the visual analog scale (EVA) and the
 Amsterdam Preoperative Anxiety and Information scale (APAIS) score, the occurrence of
 complications during gesture, satisfaction of the surgeon , Tolerance of anesthesia using the
 ISAS score, and finally a 3-month follow-up to evaluate secondary complications, resection
 margins and lesions persistence. Currently the only study on the subject is a retrospective
 study of 70 subjects. This study reported a proportion of patients with little or no
 satisfaction of 11.4%. Recruiting 80 patients will confirm this rate with an accuracy of +/-
 7%.

 The questionnaire will be given on the day of surgery and completed before surgery,
 immediately after surgery and before final discharge. Secondarily, the data will be
 supplemented during a postoperative control visit at 3 months of the intervention. The
 expected duration of the inclusions is 10 months with follow-up at 3 months

 The aim is to promote local anesthesia for the management of congested patients, thus
 simplifying the overall management, reducing the cost and reducing the complications
 associated with general anesthesia.
Inclusion Criteria:

 -  Age greater than or equal to 18 years

 -  Patient requiring conization on the CHU of Montpellier or Nîmes and having chosen a
 local anesthesia.

 -  Informed and not opposed to participate in this research

 Exclusion Criteria:

 -  Contra-indication to local anesthesia