Design: A retrospective cohort study (Canadian Task Force Classification II-2).

Setting: A single institution regional referral center (public hospital).

Patients or Participants: Patients undergoing laparoscopic hysterectomy for benign indications.

Interventions: A preoperative morphine/bupivacaine spinal injection.

Measurements and Main Results: Primary outcomes were pain scores on day of surgery (DOS) and postoperative day one (POD1) and inpatient opioid use. Pain scores were obtained using the 0 to 10 Numerical Rating Scale (NRS). Opioids were converted to oral morphine milliequivalents (OME). Three hundred nineteen patients met criteria for inclusion: 192 received spinal anesthesia and 127 did not. Baseline demographics were similar between the two groups. Median pain scores were significantly lower in the treatment than the control group on DOS (2 vs. 6; p <0.001) and POD1 (2 vs. 4; p <0.001). Median opioid use was also significantly lower in the treatment than the control group on DOS (0 vs. 15.00 OME; p <0.001) and POD1 (0 vs. 7.5 OME; p <0.001). Median length of stay between the groups was not significantly different.

Conclusion: Preoperative morphine spinal injection for laparoscopic hysterectomy led to significantly lower pain scores and inpatient opioid consumption. Preoperative spinal anesthesia for benign laparoscopic hysterectomy appears helpful for enhancing the postoperative experience.