BACKGROUND Laparoscopic surgery has become a common surgical approach for the clinical treatment of intra-abdominal lesions in recent years. We hypothesized that lumbar block with postoperative patient-controlled intravenous analgesia (PCIA) by butorphanol after gynecological surgery under general anesthesia would be more effective than PCIA by butorphanol alone. AIM To investigate the effect of lumbar block with PCIA by butorphanol after gynecological surgery under general anesthesia. METHODS This study assessed 120 women scheduled for laparoscopic surgery at our hospital between May 2017 and May 2020. They were divided using a random number table into a research group (those who received quadratus lumborum block combined with PCIA analgesia by butorphanol) and a control group (those who received only PCIA analgesia by butorphanol), with 60 patients in each group. Demographic factors, visual analog scale scores for pain, serum inflammatory markers, PCIA compressions, Ramsay scores, and adverse events were compared between groups using a t -test, analysis of variance, or χ 2 test, as appropriate. RESULTS There were no significant differences in demographic factors between groups (all P > 0.05). The visual analog scale scores of the research group in the resting state 12 h and 24 h postoperatively were significantly lower than those of the control group ( P < 0.05). Two hours after surgery, there were no significant differences in the levels of serum tumor necrosis factor-α, interleukin (IL)-6, or IL-8 between groups ( P > 0.05). The serum tumor necrosis factor-α levels of the research group 24 h postoperatively were significantly lower than those of the control group ( P < 0.05). The levels of serum IL-6 and IL-8 in the study group 24 h and 48 h postoperatively were significantly lower than those in the control group ( P < 0.05). CONCLUSION Lumbar block with PCIA with butorphanol after gynecological surgery under general anesthesia significantly improves the analgesic effect and reduces the degree of inflammation, instances of PCIA compression, and adverse reactions.