Supplemental Digital Content 4: Side-effect assessment. DEX + Ropiv 1.16 (2.35) Nausea (0-10) Ropiv P value 0.0799 2.47 (3.39) Nausea frequency (number of times nauseated) 0.548 (1.21) 1.4 (3.11) Vomiting (% patients for each score [0-10]) 0 100 93.3 3 3.3 8 3.3 Vomiting frequency (number of times vomited [% patients]) 0 100 93.3 1 3.3 15 3.3 Lack of appetite (0-10) 1.19 (2.23) 0.967 (2.14) Constipation (% patients for each score [0-10]) 0 Urinary retention (0-10) Difficulty Concentrating (010) Drowsiness (0-10) Confusion (0-10) Fatigue (0-10) Dizziness (0-10) 96.8 3.2 NA 0.0645 (0.359) 1.55 (1.98) 0.226 (0.884) 2.16 (2.24) 1.26 (1.91) 1 NA 0.8 (1.69) 1.33 (1.79) 0.267 (0.98) 2.37 (2.79) 1.2 (1.67) Itchiness (% patients for each score [0-10]) 0 96.8 90 4 3.3 5 3.3 7 3.2 10 3.3 Dry Mouth (0-10) 2.58 (2.67) 1.53 (2.16) 0.156 0.234 0.234 0.685 0.242 NA 0.0178 0.657 0.864 0.75 0.9 0.224 0.0927 Headache (0-10) 0.323 (1.08) 0.967 (1.73) 0.08 On the first postoperative day, patients completed a structured self-report measure that assessed for the symptoms listed. Patients were asked to rate each symptom on a 0-10 numeric rating scale (0 = not bad; 10 = bad as you can imagine). In addition to the 0-10 scale, the frequency of nausea and vomiting were assessed separately. Data presented as percentages or as mean (standard deviation) for normally distributed data or as the percentage (%) of patients in that particular category for non-normally distributed data.