Fifty-one patients aged 12–17 years with adolescent idiopathic scoliosis undergoing posterior spinal fusion were randomized to receive either oral caffeine (n=24) or placebo (n=27). The primary outcome of interest was total postoperative opioid consumption (MME). Secondary outcomes included pain scores, number of diazepam requests, average heart rate, average systolic blood pressure, and length of hospital stay. Outcomes were assessed during the hospital stay. Overall, the results revealed that the caffeine group had an average reduction in total opioid use by 5 MME compared to the placebo group, but the difference was not statistically significant. This suggests oral caffeine may contribute to modest opioid-sparing effects in this population, though further research is needed due to study limitations.