This is a protocol for a Cochrane Review (Intervention). The objectives are as follows:

1. To determine the effectiveness of paracervical local anaesthesia versus general anaesthesia or analgesia for cervical dilatation and uterine intervention and the incidences of adverse events after each.
2. To determine the effectiveness of paracervical anaesthesia versus systemic analgesia for postoperative pain and the incidences of adverse events after each.

Our review primary and secondary hypotheses are:

Hypothesis 1A: There is no difference in the level of pain experienced by women during cervical dilatation and uterine intervention under paracervical local anaesthesia or systemic analgesia.

Hypothesis 1B: There is no difference in the level of pain experienced (or systemic analgesia received) by patients after cervical dilatation and uterine intervention that has been performed with either paracervical local anaesthesia, general anaesthesia or systemic analgesia.

Hypothesis 1C: The pain experienced after cervical dilatation and uterine intervention that has been performed under general anaesthesia is reduced as much by paracervical local anaesthesia as it is by systemic analgesia.

Hypothesis 2: The incidences of nausea or vomiting (separate or combined) are lower following cervical dilatation and uterine intervention performed under paracervical local anaesthesia than under general anaesthesia or systemic analgesia.

Hypothesis 3: The incidence of patient dissatisfaction is less following cervical dilatation and uterine intervention performed under paracervical local anaesthesia than under general anaesthesia or systemic analgesia.

Hypothesis 4: The efficacy of paracervical local anaesthesia on the incidence of outcomes following cervical dilatation and uterine intervention is less for women before the menopause than for women after the menopause.

Hypothesis 5: The efficacy of paracervical local anaesthesia on the incidence of outcomes following cervical dilatation and uterine intervention is different for women having the operation for gynaecological reasons than it is for women having the operation for obstetric reasons.