The study was not feasible to perform at one institution with the amount of subjects that were needed to complete it.

The purpose of this study is to determine if injecting a local anesthetic, or numbing medication, above each hip will decrease the amount of narcotic pain medicine that is typically required by a patient after a cesarean delivery. Ultrasound pictures will be used to guide placement of this injection. Either ropivicaine (a type of numbing medication called a local anesthetic) or a placebo (saline) will be injected. For 24 hours, you will be given a button to press when you have pain. When the button is pressed, you will be given a small amount of pain medication called hydromorphone through your IV. You will also be given a pain medication called ketorolac through your IV every 8 hours for 24 hours after surgery.

Inclusion Criteria:

• Age 18 years or over
• ASA class 1 , 2 or 3
• BMI greater than 30 kg/m2 (as recorded at the patient's last clinic appointment or as measured on the day of delivery)
• Scheduled for cesarean section via Pfannenstiel incision (with or without a tubal ligation)
• 150 cm or taller
• Informed consent obtained

Exclusion Criteria:

• ASA class 4
• Age under 18
• Relevant drug allergy
• Contraindication to spinal anesthesia
• Height < 150 cm
• Patient receiving medical therapies considered to result in a tolerance to opioids
• Any other major surgical procedure performed other than cesarean delivery with or without tubal ligation
• Patient with relevant contraindications to ketorolac, such as history of gastrointestinal bleeding or impaired renal function
• Patient refusal