Moderate-to-severe acute pain occurs commonly following ambulatory procedures and in patients following surgery. Controlling moderate-to-severe acute pain adequately in the emergency room setting is also a challenge. Conventionally, the central acting opiates have been the keystone of postoperative analgesia; however, the adverse effect profile of opiates, such as respiratory depression, psychomotor disturbances, ataxia, sedation, constipation, tolerance, and dependence, has led some clinicians to avoid repeated dosing of opioids. This led to the use of nonsteroidal anti-inflammatory drugs (NSAIDs) in conjunction with opioids to provide adequate postoperative analgesia and minimize the adverse drug effects of opioids.