The primary objectives of this present study are to examine whether a continuous interscalene block of a total duration of 48 hours reduces the incidence of rebound pain comparatively to single-shot interscalene block, through the evaluation of the NRS scores at rest and on movement in the postoperative period at 24, 48, 72 and 96 hours as well as the total opioid consumption in the same timeframe for patients undergoing total shoulder arthroplasty.
Rebound pain has been defined in some studies as the "the transition from well-controlled pain (numerical rating scale \[NRS\] ≤3) while the block is working to severe pain (NRS ≥7) within 24 h of block performance."
Adults aged >18 years of age
ASA I-III
Scheduled for elective ambulatory total shoulder arthroplasty.
ASA IV
Revision surgery
Contraindication to regional anesthesia (such as allergy to local anesthetics, systemic anticoagulation, local infection)
Preoperative chronic pain or opioid use
Parallel
Continuous interscalene nerve block
DrugThis Interventional Group will receive a continuous interscalene block via a catheter for a duration of 48 hours with ropivacaine 0.2% at a fixed 5 mL/hour rate.
Interscalene Block
DrugThis control group will receive a single shot interscalene block with 20 mL of ropivicaine 0.2%.
incidence of Rebound pain within 96 hours postoperatively
The incidence of Rebound Pain, defined as an NRS score of \< 3 during an effective block to an NRS \> 7 within 24 hours of block resolution. This will be analyzed as a binary variable (yes/no)
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