Opioid-Free Anesthetic for Tonsillectomy

Inclusion Criteria: 1. Males or females age 2 to 18 years. 2. American Society of Anesthesiologists {ASA) ≤ 3 physical classification system 3. Girls after menarche must have a negative pregnancy test. 4. Scheduled tonsillectomy or tonsillectomy combined with adenoidectomy and/or ear tube placement at the Children's Hospital of Philadelphia (CHOP) main or ambulatory surgical centers. 5. Parental/guardian permission (informed consent) and if appropriate, child assent Exclusion Criteria: 1. Current (Within the last 30 days) opioid use for pain control 2. High risk for surgical site hemorrhage, determined by bleeding disorder diagnosis or evidence or poor hemostasis 3. Multiple scheduled surgeries at the same time other than adenoidectomy and/or ear tube placement 4. History of drug abuse, chronic pain, bleeding disorder 5. Chronic disease such as sickle cell disease for which treatment with opioids may be clinically indicated 6. Significant congenital disorders, medication allergies or comorbidities, specifically a pre-disposition to bradycardia or conduction abnormalities, cyanotic cardiac disease and use of medications that would increase risk of bleeding or bradycardia. 7. History of hepatic dysfunction, renal dysfunction, thrombocytopenia, or anemia (including pre-surgery laboratory abnormalities) 8. History of hypersensitivity to NSAIDs 9. Patients with asthma, including patients who have experienced aspirin- or NSAID-sensitive asthma or a history of exacerbation when aspirin or NSAIDs are administered (e.g. bronchospasm, urticaria, etc.) 10. Subjects receiving medications that could impact metabolism of either study drug should also be excluded 11. Trisomy 21 diagnosis 12. Parents/guardians or subjects who, in the opinion of the Investigator, may be non-compliant with study schedules or procedures. 13. Patients on a Ketogenic diet 14. Parents or subjects who do not speak English