Exparel as a Nerve Block for Severe Hand Pain

Inclusion Criteria: * American Society of Anesthesiologists (ASA) status I-IV Exclusion Criteria: * True Allergy, not sensitivity to: local anesthetics, midazolam, fentanyl, propofol, ketamine * Previous surgery or significant trauma involving the radial or ulnar arteries (previous history of angiography and intravascular catheter placement are permitted) * Pregnancy * Severe hepatic impairment * Evidence of infection at or near the proposed needle insertion site * Any sensorimotor deficit of the ipsilateral upper extremity, whether acute or chronic as determined by the PI and/or designee