The American Society of Anesthesiologists recommends acetaminophen, NSAIDS, or COX-2 inhibitors as part of a multimodal pain management strategy to limit opioid usage (1). As the surgical patient population becomes more complex with comorbidities ranging from obesity, obstructive sleep apnea , and asthma becoming more common, the medical community continues to search for efficacious analgesics with a high safety profile. While non-steroidal anti-inflammatory drugs play an important role in multi-modal analgesia, their use is limited based on concerns for platelet inhibition, asthma exacerbation, and renal artery perfusion in patients of advanced age or reduced creatinine clearance.