A Feasibility Randomized Control Comparison of Peripheral Interscalene Catheter to Liposomal Bupivacaine Single Injection for Interscalene Blocks Used in Pain Control for Total Shoulder Arthroplasties

What this Trial Is About

Researchers are evaluating two methods for managing pain after total shoulder replacement surgery: the use of an interscalene catheter and a single injection interscalene block with liposomal bupivacaine. This study aims to compare these approaches in terms of pain control, opioid use, cost, and patient outcomes, addressing the challenge of managing intense post-operative pain and improving recovery experience. Both methods are standard care options with distinct benefits and potential drawbacks, and this research seeks to identify which offers better results for patients. Participants will be randomly assigned to receive either an interscalene catheter placed pre-operatively by a skilled anesthesiologist, delivering continuous infusion of ropivacaine for 24 to 48 hours, or a single shot interscalene block using liposomal bupivacaine combined with bupivacaine. Both treatments are administered before surgery under anesthesia. The catheter method requires ongoing management of the infusion pump, while the single injection option offers prolonged pain relief through a slow-release anesthetic formulation. The study will assess these approaches during the initial hospital stay and follow patients up to three months after surgery. Throughout the study, participants will complete questionnaires evaluating pain, functionality, and quality of life before surgery and at multiple points up to six months post-operatively. Pain scores and opioid use will be tracked closely in the hospital and after discharge, with researchers also measuring costs and environmental impact related to each technique. The primary outcome is the functional pain score at one day after surgery, with additional assessments at 7, 30, and 90 days. This comprehensive monitoring aims to capture both short-term and longer-term effects of the treatments on recovery and patient satisfaction.

Comparison of Interscalene Catheter to Single Injection Interscalene Blocks for Total Shoulder Arthroplasties