Mohs micrographic surgery (MMS) is regarded as the gold standard for the treatment of
high-risk nonmelanoma skin cancer (NMSC). Pain after MMS peaks on the day of surgery and
slowly decreases thereafter. The most common post-operative analgesics include acetaminophen,
ibuprofen and narcotics. Lidocaine is the most commonly used anesthetic in MMS, but
bupivacaine has been shown in other surgical specialties to be an effective adjuvant to
reduce post-operative pain and opioid use when injected locally in the immediate
postoperative period. Bupivacaine has also been shown to reduce intra-operative pain during
MMS. The investigators plan a single-blinded prospective, randomized, controlled trial to
determine if post-operative wound infiltration of bupivacaine versus normal saline improves
post-operative pain and decreases need for post-operative pain medications including both
narcotic and nonnarcotic analgesics.