Inclusion Criteria:  Patients over the age of 18 undergoing outpatient primary 1st MTPJ fusion by a fellowship-trained foot and ankle orthopaedic surgeon at the Rothman Orthopaedic Institute  Exclusion Criteria:  Patients undergoing revision 1st MTPJ fusion; Patients with any allergies to any study medication; Patients with documented chronic narcotic use; Patients with renal insufficiency, as defined by history and preoperative creatinine level (Cr ≥ 2.1 mg/dl); Patients who are pregnant; Patients undergoing inpatient procedure.