178 patients with conditions requiring lumbar fusion were randomized to receive either intravenous ketorolac (n=60), intravenous acetaminophen (n=58), or intravenous placebo (n=60). The primary outcome of interest was in-hospital opioid use up to 72 hours. Secondary outcomes included opioid-related adverse events, incidence of radiographic fusion, length of stay, worst, average, best, and current pain using the Brief Pain Inventory (BPI) scale, Oswestry Disability Index (ODI), Veteran's Rand 12-item Health Survey (VR-12) Physical Component Score (PCS), and the VR-12 Mental Component Score. All outcomes were assessed up to 72 hours post-surgery, whereas ODI and VR-12 scores were assessed at 3 months, 1, and 2 years. Overall, the results of the study revealed that patients receiving intravenous ketorolac had significantly lower opioid use and shorter hospital stays compared to the other groups, with no increase in adverse events or pseudarthrosis. The findings suggest that intravenous ketorolac is an effective component of enhanced recovery after surgery protocols for patients undergoing lumbar fusion.