Can aggressive postoperative non-narcotic therapy replace narcotics in patients undergoing laparoscopic hysterectomies?

Background Pain, although invariably present after surgical procedures, is not always well controlled. Medications from different analgesic groups are often used to control post-operative pain. Recently, attention has turned towards the optimization of non-opioid analgesics including NSAIDS and acetaminophen. After gynaecologic laparoscopy up to 80% of patients may require opioid analgesia. However, opioids can have adverse effects including nausea, vomiting, sedation, and respiratory depression. Thus the prudent surgeon attempts to use a narcotic-sparing approach to postoperative analgesia. Theoretically, aggressive non-narcotic analgesic administration will result in less narcotic use. Fortunately, both NSAIDs and acetaminophen are very effective in the control of moderate to severe pain and have few side effects. Our research question then is: “What is the post-operative narcotic use amongst women undergoing laparoscopic hysterectomy who receive aggressive non-narcotic therapy?”