BACKGROUND: The use of nonnarcotic analgesics, such as ketorolac, has been shown to reduce postoperative pain and opioid consumption. This double-blinded randomized trial is designed to assess the efficacy of intraoperative ketorolac in reducing postoperative narcotic use in outpatient breast reconstruction and reduction procedures. METHODS: This study is a prospective double-blinded randomized controlled trial. Adult patients, 18-64 years of age, undergoing breast surgery were randomized to receive 15 mg of ketorolac, 30 mg of ketorolac, or a placebo dose of saline. Patients' opioid requirements in the postoperative anesthesia care unit and postoperative opioid utilization and pain scores were collected through a daily survey. Postoperative hematomas were assessed before discharge and at subsequent follow-up visits for a period of 14 days. RESULTS: Of the 63 patients included in the study, 31 patients underwent delayed reconstruction following mastectomy and 35 patients underwent breast reduction surgery. Patients who received 30 mg of ketorolac had the fastest pain resolution ( CONCLUSIONS: This study demonstrates that a single dose of intraoperative ketorolac was associated with reduced opioid usage and postoperative pain. However, due to the study size, the difference in hematoma rate was not statistically significant.