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.