Interscalene Block With Liposomal Bupivacaine vs. Interscalene Block With Bupivacaine and Adjuvants

Inclusion Criteria: * All patients undergoing total shoulder arthroplasty (not a reverse) * Age ≥ 18 years * Ability to understand and the willingness to sign an IRB-approved informed consent document. * ASA patient status I-III patients * Weight Greater than or equal to 50 kg Exclusion Criteria: * Contraindications to an interscalene block or phrenic blockade * Infection at injection site * Pre-existing neurological dysfunction affecting the operative extremity * Chronic pain diagnosis or opioid use \>40mg oxycodone daily equivalents or use of long-acting opioids * BMI \>40 * Uncontrolled diabetes (A1c \>8.0) * Concurrent painful physical condition requiring analgesic treatment (eg, NSAID or opioid) in the postsurgical period for pain not strictly related to the surgery * Contraindications to any pain-control agents planned for surgical or postsurgical use (i.e., bupivacaine, hydromorphone, etc.) * Patients who are wards of the state * History of allergic reactions attributed to compounds of similar chemical or biologic composition to bupivacaine or liposomal bupivacaine. * Patients with moderate-severe hepatic or renal impairment