Evaluating Intercostobrachial Nerve Block's Effect on Pain Control After Shoulder Replacement

Inclusion criteria

• Adult patients 18-80 years old
• Adult patient's BMI <= 35
• Individuals presenting for primary total shoulder arthroplasty or reverse total shoulder arthroplasty
• Anticipated discharge home same day of surgery
• Patient is able to provide informed consent to participate in the study.

Exclusion criteria

• Patient presenting for revision shoulder surgery
• Allergy to amide local anesthetic, liposomal bupivacaine or other medication involving liposomal formulation
• Preexisting neurological deficits involving or potentially involving the ipsilateral brachial plexus
• Preexisting contralateral vocal fold paralysis or recurrent laryngeal paralysis
• Psychiatric or cognitive disorders that could interfere with perioperative evaluation including drug or alcohol abuse
• Chronic pain conditions
• Preoperative opioid use
• Moderate to severe pulmonary disease
• Moderate to severe sleep apnea
• Planned postoperative admission.
• Unplanned postoperative admission
• Any contraindication to interscalene or intercostobrachial nerve block including any local disorder of the skin where blockade is to be performed which would prevent safe performance of the block
• Any coagulation abnormality which would be a contraindication for block placement
• Preoperative chronic renal dysfunction requiring renal replacement therapy or CrCl < 60
• Sulfa allergy (or other reason patient cannot receive celecoxib)
• Allergy or intolerance to any medication in the protocol
• Body mass index >35
• Pregnancy
• Incarceration
• ASA classification greater than 3
• Inability to provide informed consent
• Refusal to participate in the study