The purpose of this study is to compare the effect of liposomal Bupivacaine infiltration into the shoulder to continues nerve block with Bupivacaine on postoperative pain control and functional outcomes.

liposomal bupivacaine analgesia will provide improved postoperative pain control, reduction in amount of opioid supplementation, decreased complications and faster return to function compared to current standard of care pain management for patients undergoing shoulder arthroplasty and shoulder surgery for proximal humerus fractures.

Inclusion Criteria:

• Patients undergoing shoulder arthroplasty under general anesthesia
• Patients undergoing open reduction internal fixation (ORIF) of a proximal humerus fracture under general anesthesia
• Patients with American Society of Anesthesiologist (ASA) physical status classification of 1-3
• Patients meeting criteria for standard of care continuous peripheral nerve block (CPNB) per anesthesia guidelines.
• Patients agreeing to be available for brief follow up telephone survey post- operatively and being mentally able to respond.
• Patients available for follow up routine post-operative clinic visits, per standard of care.

Exclusion Criteria:

• Contraindications to regional anesthesia
• Significant peripheral neuropathy or neurological disorder affecting the upper extremity
• Contraindication to a component of multimodal analgesia
• Pregnancy
• Opioid tolerance
• Cognitive or psychiatric condition that might affect patient assessment and/or inability to provide informed consent.

Three months

• The NRS pain scale has been associated with higher patient-reported pain scores
• Surgeons were not blinded to intervention as they had to perform the injection
• Surgeons were involved with the assessment portion of the outcome evaluations