Clinical Research Directory

Inclusion Criteria: * Unlabored, scheduled primary or repeat cesarean delivery * Cesarean performed by obstetrician or surgically-trained family medicine physician * Ability to complete numeric pain scale assessment and surveys * Patients who do not speak English but are able to converse via an interpreter both in person and by phone Exclusion Criteria: * Complications requiring return to the operating room * Unscheduled deliveries * \<18 years old, \>45 years old * Twin deliveries * Preterm deliveries (\<37 wks) * Current or previous history of opioid-substance use disorder according to patient report or medical chart * Prescription of opioid medication filled in previous 30 days prior to delivery according to patient report, documentation in electronic medical record, or documentation in the prescription drug monitoring program * Allergy to local anesthetics or NSAIDs * Cardiovascular disease, eg arrhythmia, or ASA (American Society of Anesthesiologists) Class III or higher * Diagnosis of liver disorder or dysfunction including fatty liver of pregnancy, preeclampsia with severe features including liver or kidney involvement * Known significant renal disease, oliguria, or Cr \>1.1. * Platelet count less than or equal to 90k or rapid decline in third trimester or other coagulopathy * Infection overlying the regional anesthesia site * Hypovolemia prohibiting regional anesthesia * General anesthesia