Problem & Purpose: Despite the opioid crisis being the leading cause of intoxication-related deaths in a major metropolitan area, accounting for 93% of cases in 2019, fatalities continue to rise. Studies indicate that administering intravenous magnesium sulfate at a dosage of 30–50 mg/kg at induction significantly decreases intraoperative opioid use while providing pain relief equivalent to intravenous morphine. However, the anesthesia department at a community hospital has yet to adopt magnesium sulfate as a non-opioid adjuvant in complex orthopedic procedures where intravenous opioids are frequently used. The purpose of this quality improvement project was to incorporate intravenous magnesium sulfate administration among patients undergoing complex orthopedic procedures in the anesthesia department of a large metropolitan area. Methods: An interdisciplinary team of stakeholders developed a structured, evidence-based implementation plan. Anesthesia providers (n = 18) received education on the benefits of magnesium sulfate. The pharmacy manager ensured consistent inventory in all medication dispensing machines (Pyxis) and monitored weekly availability. Educational flyers, reminder stickers in operating rooms, and weekly emails reinforced provider awareness. Chart audits tracked adherence over 15 weeks, impacting 45 patients. Results: Between September and December 2024, magnesium sulfate was stocked in 97% of Pyxis machines, ensuring accessibility. Of the 45 patients who underwent complex orthopedic procedures, 12 received magnesium sulfate, reflecting moderate adherence of 27%. Conclusion: Despite consistent stocking, provider administration was inconsistent. A noted barrier was intraoperative labile blood pressure, a contraindication to its use. Some providers opted out despite reminders and education. Efforts to involve more providers in the initiative may help to increase buy-in.