Download Full Text (730 KB)


Orthopedic Surgery

Training Level

Resident PGY 2


Henry Ford Hospital


Purpose: Interscalene nerve block (INB) and liposomal bupivacaine (LB) have been previously found to provide adequate pain control following shoulder arthroplasty. We hypothesized that local infiltration of a peri-articular cocktail (LIC) would provide equivalent pain control compared to INB and LB at a decreased cost. Methods: Eighty-six patients undergoing primary shoulder arthroplasty were consented for participation. Patients were treated with either LIC (200 mg of 0.5% ropivacaine/1 mg epinephrine/30 mg ketorolac), local infiltration of LB (20mL bupivacaine/20mL saline), or preoperative INB. The primary outcome of the study was postoperative average visual analog scale (VAS) scores accessed for 4 days. Secondary outcomes included opioid consumption, length of stay, and complications. Results: A total of 29 patients receiving LIC, 26 receiving LB and 31 receiving INB were included in the study. Patients who received LIC had a significantly lower mean VAS on post-operative day (POD) 0 when compared to INB (2.46 vs. 3.95, p

Presentation Date


Does the use of peri-articular anesthetic cocktail provide adequate pain control following shoulder arthroplasty?