LIBERATE - LIposomal Bupivacaine vERsus Adjuncts in Total shouldErs

Exclusion Criteria

• •Presence of a language barrier;
• •Inability to complete telephone and/or paper questionnaire;
• •Lack of consent;
• •Allergy to local anesthetic;
• •Chronic pain syndrome and/or preoperative opioid use \> 50 MME per day (including extended-release formulations and methadone);
• •Preoperative consultation to chronic pain service;
• •History of (\<3 months) or current substance abuse, including any illicit drugs or excessive alcohol consumption as defined by the Office of Disease Prevention and Health Promotion (4 or more drinks per day or 8 or more drinks per week for women and 5 or more drinks per day or 15 or more drinks per week for men);
• •Baseline peripheral neuropathy of the brachial plexus;
• •Contraindication to receiving single shot peripheral nerve blockade; including antithrombotic medications as per most recent American Society of Regional - - -Anesthesiology (ASRA) guidelines 17 , coagulopathy or coagulation disorder, or infection at injection site;
• •Severe chronic obstructive pulmonary disease (COPD) or other significant pulmonary disease where interscalene nerve block would be contraindicated due to concern for respiratory failure from phrenic nerve palsy;
• •Weight \< 45 kg, given concern for local anesthetic toxicity at dosages given for the study; ASA score IV-V;
• •Revision arthroplasty;
• •Anatomic abnormality that limits or prevents the patient from receiving an interscalene nerve block;
• •Pregnant, nursing, or planning to become pregnant during the study or within 1 month after the shoulder replacement surgery