Clinical Research Directory

Inclusion Criteria: * Women ≥ 40 years and ≤ 80 * BMI \>=18.0 and \<= 40.0 * Can read and speak English or Spanish * Undergoing major urogynecologic surgery, defined as having at least one of the following: * Robotic-assisted laparoscopic sacrocolpopexy * Uterosacral ligament suspension (laparoscopic or vaginal approach) * Uterosacral hysteropexy * Sacrospinous hysteropexy * Sacrospinous ligament fixation * Conversion to laparotomy during primary surgery for prolapse repair Exclusion Criteria: * • Current narcotic use defined as daily use for more than 7 consecutive days in the 3 months prior to surgery, or current treatment for opioid use disorder. * Any opioid use within 30 days prior to the scheduled procedure date. * Significant hepatic disease, defined as AST or ALT \>3 times the upper limit of normal or Child-Pugh class B or C. * Diagnosis of chronic pain syndrome or fibromyalgia * Inability to provide written informed consent * History of significant respiratory, cardiovascular, metabolic, neurologic, or psychiatric disease as deemed clinically significant by study team * History of cardiac dysrhythmias requiring anti-arrhythmia treatment(s) within the last 2 years or QT prolongation (QTcF \>450 ms) or pacemaker/ICD * Severe kidney disease define as Estimated glomerular filtration rate (eGFR) of ≤ 30ml/min * Inability to receive or respond to text messages via mobile phone * Receives transversus abdominis plane (TAP) block * Allergy to any of the study medications * Use of moderate or strong CYP3A inducers or inhibitors, including prescription medications, over-the-counter medications, and herbal supplements known to significantly affect CYP3A metabolism (e.g., ketoconazole, clarithromycin, rifampin, carbamazepine, phenytoin, ritonavir, and St. John's Wort). * Pregnant or breastfeeding or planning to become pregnant within 30 days following last dose of study drug