Laparoscopic gynecological surgery is minimally invasive, but often causes significant postoperative pain with somatic, visceral, and referred components. This pain complicates the patient's recovery and increases the consumption of opioids, therefore, effective opioid-sparing analgesia is needed within ERAS (Enhanced Recovery After Surgery) protocols. A narrative review describes the evolution of regional nerve blocks from early techniques such as local infiltration to ultrasound-guided fascial plane blocks. Supporting evidence focuses on the main blocks: transversus abdominis plane block (TAPB), Quadratus Lumborum Block (QLB) and Erector Spinae Plane Block (ESPB), which also address visceral pain. The efficacy and duration of the blocks are optimized by pharmacological adjuvants such as dexamethasone and dexmedetomidine or by adjusting the doses. Regional blocks form the basis of multimodal analgesia to accelerate recovery and improve patient outcomes. The future is moving towards personalized analgesia tailored to specific surgical procedures and patient needs using advanced technology.