50 patients undergoing one- or two-level anterior cervical discectomy and fusion or anterior cervical disc arthroplasty were randomized to either an opioid-free (OF) (n=22) or opioid-containing (OC) (n=28) perioperative pain management protocol. Outcomes of interest include opioid consumption, measured in-hospital and at 2 and 6 weeks using morphine milligrams equivalents (MME); numeric pain rating scale (NRPS), assessed preoperatively, at 6, 12, and 24 hours, and 2- and 6-weeks postoperative; patient comfort assessed at 6, 12 and 24 hours; and patient satisfaction with pain control assessed at 2 weeks and 6 weeks. In terms of pain control, the OF group reported better pain levels at 6 and 24 hours and similar pain levels to the OC group at 12 hours and 2 and 6 weeks. Patient comfort and patient satisfaction were similar between groups at all time points.