Intercostal Liposomal Bupivacaine for the Management of Blunt Chest Wall Trauma

Inclusion Criteria: * Anticipated length of stay of at least 72 hours * Blunt chest wall trauma with two or more rib or sternal fractures * Demonstrated ability to achieve \> 50% predicted inspiratory capacity based on ideal body weight using IS within the first 24 hours of admission Exclusion Criteria: * Known allergy to bupivacaine * Respiratory failure requiring intubation within 24 hours prior to enrollment * Known or suspected atrioventricular nodal blockade process requiring cardiology evaluation or pacemaker placement * Hemodynamic instability (defined as new intravenous vasopressor or inotrope requirement or mean arterial pressure \< 55 mmHg) * Signs of active myocardial ischemia or non-ST elevation MI * \> 20 rib fractures * Weight \< 50 kg or \> 150 kg * Pregnancy * Incarceration