Liposomal Bupivacaine vs Perineural Adjuvants in Adductor Canalf and iPACK Blocks in Total Knee Arthroplasty

Inclusion Criteria: * 18-80 years of age * Receiving primary total knee arthroplasty * Patients receiving a spinal anesthetic with ropivacaine and fentanyl * American Society of Anesthesiology (ASA) category 1 to 3 Exclusion Criteria: * Revision of Total Knee Arthroplasty * Opioid use in the prior 6 months \> 40 mg oxycodone equivalents per day or long-acting opioids as determined by the Prescription Drug Monitoring Program (PDMP) * Patients planned to receive general anesthesia * Patients planned to receive a spinal other than ropivacaine * History of peripheral neuropathy * Poorly controlled diabetes (Hgb A1C \>8) * Allergies or contraindications to study medications: acetaminophen, celecoxib (including sulfa), methocarbamol, midazolam, fentanyl, bupivacaine, dexamethasone, acetaminophen, buprenorphine, NSAIDs, clonidine, epinephrine, and liposomal bupivacaine. * Unable to provide informed consent