I had it done under general anesthesia. When I saw the illustration on the brochure I was given, I had an anxiety attack on the spot. The first ex-doctor told me it just scooped out abnormal tissue, but according to the illustration, it was clearly going to gouge a big hole in my cervix! The brochure also said the doctor would give me shots in my cervix to numb it. Even just a simple shot for dental work hurts a LOT, for me. Did she think I was going to be awake and hold still for all of this? Absolutely not!
I don't know why doctors, in general, don't discuss a patient's pain tolerance and comfort level. Perhaps it's the insurance companies wanted doctors to be quick and cost effective about it. But it is up to us to tell a doctor what we need and to make them respect that. Each woman's body is different.
For some women, they just want the abnormal tissue removed, so it's no big deal. They go to the doctor's office, get it over with, and go home. For others, the anxiety level is such, anti-anxiety medication is best. For others, the pain tolerance and/or anxiety level is such, it's best to to it via "twilight" in-office. And for still other women, general anesthesia is best.
There are always risks with general anesthesia. But a frightened patient with no pain tolerance is going to be a bigger risk.