Overview
Randomized control study that compares different concentrations of local anesthetic to investigate whether a lower concentration of local anesthetic would contribute to lower rebound pain scores at 24 hours post op in patients undergoing anatomic or reverse total shoulder arthroplasty.
Eligibility
Inclusion Criteria:
- Total shoulder replacement patients (anatomic and reverse)
- Adult patients (greater than or equal to 18 years)
- Any gender
- Any race
Exclusion Criteria:
- \- Chronic Pain diagnoses including:
- substance/opioid use disorder
- complex regional pain syndromes
- fibromyalgia
- Daily persistent opioid use spanning 3 months prior to surgery date
- Allergy to local anesthetics or NSAIDS
- Respiratory pathologies including:
- CPAP- non-compliant / untreated obstructive sleep apnea
- COPD
- Restrictive lung disease (pulmonary fibrosis, interstitial pneumonia, etc)
- Contralateral diaphragm dysfunction
- BMI \> 40
- Ipsilateral extremity pre-existing nerve injury
- GFR \< 60
- NSAID contraindications
- Inability to follow up
- Revision surgery
- Patients requesting block as primary (avoidance of general anesthesia)
- Need or request for brachial plexus catheter or liposomal bupivacaine
- Vulnerable populations (pregnancy, incarceration, etc)
- non-English speaking
