Franz AM, et al. - Given the recent national opioid shortage, anesthesiologists at Bellevue Surgery Center sought for an alternative perioperative analgesic regimen that could minimize opioids yet provides effective pain relief. An interdisciplinary quality improvement team was assembled by researchers to trial a series of analgesic protocols using the Plan-Do-Study-Act cycle. Initially, intraoperative morphine and acetaminophen (M/A protocol) were replaced with intraoperative dexmedetomidine and preoperative ibuprofen (D/I protocol). However, a rapid transition to intraoperative ketorolac and dexmedetomidine (D/K protocol) was done in case of unfavorable results. Three hundred thirty-three patients were there in the M/A protocol, 211 patients were in the D/I protocol, and 196 patients were in the D/K protocol. With the D/I protocol, maximum pain score and postanesthesia care unit length of stay showed small increases, but morphine rescue rate or total anesthesia time were not different when compared to the M/A protocol. Postoperative pain control and postanesthesia care unit length of stay were similar between the D/K protocol and the M/A protocol. This study thereby suggests an intraoperative anesthesia protocol utilizing dexmedetomidine and ketorolac that could produce effective analgesia without increasing recovery times or reoperation rates for pediatric tonsillectomy and adenotonsillectomy surgery.