To the Editor We read with great interest the article by Kelley-Quon et al1 and commend the authors for creating these guidelines and applaud recommendations to minimize opioid use while using regional anesthesia and nonpharmacologic techniques as appropriate.1 However, as members and representatives of the Society for Pediatric Pain Medicine, a section of the Society for Pediatric Anesthesia, we must express concern with the undue emphasis on avoiding opioids altogether, an approach not supported in the current literature.1,2