In recent years, there has been an emphasis on the creation of "enhanced-recovery", "fast-track" or "multi-modal" pathways to improve perioperative care (1-4). The goal of these programs is to reduce the length of hospital stay, decrease narcotic usage while improving pain control, accelerate post-operative recovery, and expedite return to baseline functional status. Pathways often are developed by a team of surgeons, nurses, pain specialists, anesthesiologists and other support staff. Postoperative components often involve multi-modal analgesia, early return to activity and early return to a regular diet. The goal of this study is to evaluate the efficacy of a multi-modal pain regimen in advanced pelvic surgery with a primary goal of decreasing narcotic usage.

Inclusion Criteria:

• women >/= 18 years old
• undergoing pelvic organ prolapse or incontinence surgery with the Urogynecology department

Exclusion Criteria:

• males
• <18 years old
• women unwilling or unable to consent
• same-day-discharge surgery
• history of chronic pain for which they use medications
• current or active history of narcotic abuse
• sleep apnea
• liver or kidney dysfunction
• sulfa allergy