Do Local Liposomal Bupivacaine and Interscalene Nerve Block Provide Similar Pain Control After Shoulder Arthroplasty? A Dual-center Randomized Controlled Trial

Abstract Background Interscalene nerve block (INB) has become a popular technique for shoulder anesthesia. However, INB is associated with complication rates as high as 20%. Local liposomal bupivacaine (LLB) is an alternative to INB that potentially offers extended pain control with fewer adverse effects. Methods We conducted a dual-center randomized controlled trial of 108 participants who were treated with LLB or INB (n = 54 each) to control pain after shoulder arthroplasty. We assessed VAS pain scores at 6-hour intervals from 6 to 96 hours postoperatively and at the first postoperative visit. We assessed opioid medication consumption intraoperatively and at days 1, 2, 3, and 4 postoperatively, and the duration of hospital and PACU stays. Results At 6 hours postoperatively, mean VAS pain score was lower in the INB group (2.9 ± 3.1) than in the LLB group (5.1 ± 2.9) (p Conclusions Compared with LLB, INB provides better pain control immediately after shoulder arthroplasty as evidenced by shorter PACU stays, lower pain scores at 6 hours postoperatively, and less opioid medication consumption during the first 24 hours postoperatively. However, no differences in outcomes were observed between groups beyond 24 hours.