Paracervical block with lignocaine: an underutilized adjunct to enhanced recovery in laparoscopic hysterectomy and myomectomy

Abstract

Enhanced Recovery After Surgery (ERAS) protocols are increasingly adopted in all types of surgeries including laparoscopic gynaecological procedures. They are particularly effective in reducing surgical stress, opioid consumption, and hospitalization duration. However, perioperative pelvic and referred back pain remain a significant barrier to early ambulation and discharge. This perspective highlights the potential value of reintroducing paracervical block (PCB) with lignocaine as an underutilized, simple, and effective analgesic technique that complements ERAS goals. Drawing from our institutional experience, PCB has demonstrated a reduction in opioid use, faster mobilization, and improved patient satisfaction with minimal risk. This perspective calls for wider adoption, systematic evaluation, and integration of PCB in laparoscopic gynaecological surgery. Observed benefits were confined to laparoscopic hysterectomy and myomectomy, particularly procedures involving uterine manipulation and colpotomy.

Keywords: Paracervical block; Lignocaine; Enhanced Recovery After Surgery; ERAS; Laparoscopy; Gynaecological surgery; Opioid-sparing analgesia

Citation: Gnanarathne S, Ratnayake A, Isurindi UA. Paracervical block with lignocaine: an underutilized adjunct to enhanced recovery in laparoscopic hysterectomy and myomectomy. Anaesth. pain intensive care 2026;30(3):402-404. DOI: 10.35975/apic.v30i3.3186

Received: January 29, 2026; Accepted: March 06, 2026