Study of A Long Lasting Local Anesthestic for Hand, Wrist or Finger Surgery

Inclusion Criteria: * patients 18 years or older having hand, wrist, or finger surgery * ability to understand and provide informed consent * American Society of Anesthesiologists status I-III * presence of a responsible adult caregiver for 48-72 hours after surgery Exclusion Criteria: * patient refusal or inability to provide informed consent * true allergy, not sensitivity to local anesthetics, midazolam, fentanyl, hydromorphone, propofol * pregnancy * hepatic or renal failure * evidence of infection at or near the proposed needle insertion site * any sensorimotor deficit of the upper extremity * BMI greater than or equal to 35 * uncontrolled or severe pulmonary disease * anticoagulant use (not aspirin or non-steroidal anti-inflammatories) * chronic pain patients