Interscalene Block With Liposomal Bupivacaine vs. Interscalene Block With Bupivacaine and Adjuvants

The primary objective of this clinical study is to evaluate the comparative efficacy of
interscalene block (ISB) using plain bupivacaine with adjuvants vs. liposomal bupivacaine on
mean postoperative pain levels in patients who have undergone shoulder arthroscopy within the
first 48 hours. Principal Investigators hypothesize that ISB using plain bupivacaine with
adjuvants will provide similar pain relief as ISB using liposomal bupivacaine.

Inclusion Criteria:

- All patients undergoing shoulder arthroscopy

- Age ≥ 18 years

- Ability to understand and the willingness to sign an IRB-approved informed consent
document.

- ASA patient status I-III patients

- Weight Greater than or equal to 50 kg

Exclusion Criteria:

- Contraindications to an interscalene block or phrenic blockade

- Infection at injection site

- Pre-existing neurological dysfunction affecting the operative extremity

- Chronic pain diagnosis or opioid use >40mg oxycodone daily equivalents or use of
long-acting opioids

- BMI >40

- Uncontrolled diabetes (A1c >8.0)

- Concurrent painful physical condition requiring analgesic treatment (eg, NSAID or
opioid) in the postsurgical period for pain not strictly related to the surgery

- Systemic glucocorticoids, gabapentin, pregabalin, or duloxetine within 3 days of study

- Contraindications to any pain-control agents planned for surgical or postsurgical use
(i.e., bupivacaine, hydromorphone, etc.)

- Patients who are wards of the state

- History of allergic reactions attributed to compounds of similar chemical or biologic
composition to bupivacaine or liposomal bupivacaine.

- Patients with moderate-severe hepatic or renal impairment