Carolyn,
I had my tubes tied almost 17 years ago, so some of my experience may be out of date. However, it was a breeze. They put me to sleep and I woke up in the recovery room. They did the incision right inside my belly button and put a couple of stitches in there. I don't remember any pain or discomfort afterwards at all. Maybe a little, but compared to child birth...
For my last child, the epidural didn't take effect until AFTER the child was born, but I had no problem with the anesthesia used for the tubal.
Once in a while it has made me sad that I was unable to have more children, but for the most part I have enjoyed the freedom of knowing that my family is complete and I don't have to worry about contraceptives anymore.
If you know that for sure, and no matter what, you will NEVER want to have another child, then go ahead. The questions the doc asked me were, "What if one of your children dies?" "What if your husband dies and you get remarried?" These are the kinds of questions you have to search your soul for the answer, and if you know that you still would not want another child even under the most dire of circumstances, then the surgery is a safe and secure procedure.
I wish you all the best,
L.