| Study | Route | Dose |
| Al‐Sunaidi 2007 | Intracervical versus intra and paracervical | Local intracervical anaesthesia compared to combined intracervical and paracervical anaesthesia. 0.5% bupivacaine hydrochloride into anterior wall of cervix compared to 0.5% bupivacaine hydrochloride into anterior wall of cervix plus bupivacaine into lateral vaginal fornix at 3 and 9 o’clock at 10 mm depth |
| Arnau 2013 | Endocervical topical cream | 3 mL of EMLA cream 5% or 3 mL ultrasound gel applied in the endocervical canal 10 min before surgery with 5 mL needleless syringe via speculum. A subsequent application of either gel was made with a swab at ectocervix level during vaginoscopic approach |
| Broadbent 1992 | Intracervical | Intracervical injection of 10 mL of lignocaine 1% with 1:200 000 adrenaline or normal saline was injected into the cervix at 1, 5, 7, and 11 o’clock |
| Cicinelli 1997 | Transcervical | 2 mL of 2% mepivacaine or 2 mL of 0.9% saline injected trans cervically (inserted up the cervical canal to the internal os) |
| Cicinelli 1998 | Paracervical | 10 mL of 1.5% mepivacaine or saline injected into junction of cervix and vagina (4 and 8 o'clock positions) |
| Clark 1996 | Topical spray | 10 mL of 2% lignocaine gel, placebo gel or no gel administered into cervical canal. Some women received intracervical lignocaine block if determined to need cervical dilatation |
| Costello 1998 | Intrauterine | 5 mL of 2% lignocaine or 5 mL or 0.9% saline injected into cervical canal and uterine cavity via hysteroscope |
| Esteve 2002 | Intracervical | Intracervical application at 1, 5, 7 and 11 o'clock positions of 4 x 2 mL ampoules of 2% lidocaine hydrochloride ampoules or saline |
| Finikiotis 1992 | Paracervical versus uterosacral | 20 mL of 1% lignocaine paracervical block or 2 mL of 2% lignocaine uterosacral block |
| Giorda 2000 | Paracervical | 20 mL of 1% mepivacaine injected paracervically at 3, 5, 7 and 9 o'clock position of the junction of cervix and vagina at least 5 min before the procedure |
| Kabli 2008 | Intracervical versus intracervical and intrauterine | 2 mL of 1% lidocaine into anterior wall. Distension medium of either saline only or 18 mL of lidocaine in 250 mL of saline |
| Kokanali 2013 | Intracervical | Intracervical local anaesthesia (10 mL of 1% prilocaine) was applied at the 4 and
8 o’clock position on the posterior lip of the cervix in divided doses |
| Lau 1999 | Paracervical | Paracervical block at 3, 5, 7 and 9 o'clock positions of 10 mL of 2% lignocaine or saline, 5 min prior to procedure |
| Lau 2000 | Transcervical | Transcervical intrauterine instillation of 5 mL of 2% lignocaine or normal saline into the uterine cavity 5 min before procedure |
| Lukes 2015 | Para/intracervical versus intracervical only anaesthetic block | The para/intracervical group received a total of 37 cc of anaesthesia injected at 6 different sites. 2‐3 min prior to the injection, topical 1% lidocaine was applied to the cervix in this group. The intracervical group received a total of 22 cc of anaesthetic given at 3 different injection sites |
| Makris 2001 | Intracervical | 1 mL to 3 mL (30 to 90 mg) of mepivacaine 3% or saline administered intracervically 3 min prior to procedure |
| Mercorio 2002 | Intracervical versus NSAID | 5 mL mepivacaine 2% intracervically up to the level of the internal os or one tablet of dexketoprofen given 1 h before the procedure |
| Mohammadi 2015 | Transcervical intrauterine lidocaine instillation versus rectal diclofenac | 5 mL of 2% lidocaine or the same volume of saline was instilled through the endocervix into the uterine cavity with an 18‐gauge angiocatheter 3 min prior to the procedure |
| Senturk 2016 | Intracervical | The second group was administered with a 1000 mL distention medium containing 18 mL lidocaine per 250 mL (Jetokain ampoule 20 mg 2% Adeka, Samsun, Turkey) |
| Soriano 2000 | Topical spray | 30 mg (3 metered doses) of lignocaine or placebo sprayed onto surface of cervix and cervical canal through 360° 5 min prior to procedure |
| Stigliano 1997 | Topical cream versus topical spray | 1 cm3 of 5% prilocaine cream onto esocervix and 2 cm3 inserted 3 cm into cervical canal 10 min before procedure or 20 mg of lidocaine spray directed onto esocervix and 20 mg 3 cm into cervical canal immediately before procedure or no intervention |
| Van den Bosch 2011 | Intrauterine | Unspecified volume of Instillagel (contains 2% lidocaine) or Endosgel (does not contain local anaesthetic) warmed to 37°C and instilled via a 2 mm neonatal suction catheter as part of sonography procedure 30 min prior to hysteroscopy |
| Vercellini 1994 | Paracervical | Paracervical block at 3, 5, 7 and 9 o'clock positions of 10 mL 1% mepivacaine 5 min before procedure or no intervention given |
| Wong 2000 | Topical gel | 4 mL of 2% lignocaine or placebo gel applied onto cervix before procedure |
| Zupi 1995 | Intrauterine | 5 mL of 2% mepivacaine or 5 mL of saline intrauterine via 3 mm catheter |
