Effect of Local Anesthetic Concentration on Rebound Pain

Randomized control study that compares different concentrations of local anesthetic to investigate whether a lower concentration of local anesthetic would contribute to lower rebound pain scores at 24 hours post op in patients undergoing anatomic or reverse total shoulder arthroplasty.

Inclusion Criteria: * Total shoulder replacement patients (anatomic and reverse) * Adult patients (greater than or equal to 18 years) * Any gender * Any race Exclusion Criteria: * \- Chronic Pain diagnoses including: * substance/opioid use disorder * complex regional pain syndromes * fibromyalgia * Daily persistent opioid use spanning 3 months prior to surgery date * Allergy to local anesthetics or NSAIDS * Respiratory pathologies including: * CPAP- non-compliant / untreated obstructive sleep apnea * COPD * Restrictive lung disease (pulmonary fibrosis, interstitial pneumonia, etc) * Contralateral diaphragm dysfunction * BMI \> 40 * Ipsilateral extremity pre-existing nerve injury * GFR \< 60 * NSAID contraindications * Inability to follow up * Revision surgery * Patients requesting block as primary (avoidance of general anesthesia) * Need or request for brachial plexus catheter or liposomal bupivacaine * Vulnerable populations (pregnancy, incarceration, etc) * non-English speaking