Analgesic Efficacy of Interscalene Nerve Block Versus Local Infiltration Analgesia Following Total Shoulder Arthroplasty

Inclusion criteria: 1. Adult patients with an American Society of Anesthesiologists (ASA) physiological status I-III 2. Patients presenting for unilateral primary total shoulder arthroplasty (includes anatomic and reverse total shoulder arthroplasty). 3. Patients 18 years of age and older 4. Able to provide informed consent for him or herself Exclusion Criteria: 1. Chronic pain syndromes such as fibromyalgia or complex regional pain syndrome 2. Chronic opioid use (\>1 mos) with oral morphine equivalents (OME) \>5 mg/day OR acute opioid use (\< 1 mos) with OME \> 30 mg/day. 3. Body mass index (BMI) \> 45 kg/m2 4. Severe drug allergy\* to medications used in this study, including non-steroidal anti-inflammatory drugs (i.e. celecoxib and ketorolac), and local anesthetics. 5. History of Malignant Hyperthermia. 6. Major systemic medical problems such as: * Pre-existing severe renal disorder defined as glomerular filtration rate (GFR) \<50 units/m2 (if labs are available), currently on dialysis, or highly suspected based on history. * Severe hepatic disorder defined as current or past diagnosis of acute/subacute necrosis of liver, acute hepatic failure, chronic liver disease, cirrhosis (primary biliary cirrhosis), chronic hepatitis/toxic hepatitis, liver abscess, hepatic coma, hepatorenal syndrome, other disorders of liver * Pre-existing medical history of moderate to severe pulmonary disease (obstructive and/or restrictive), use of home oxygen, preoperative baseline oxygen saturation \< 94% on room air, forced expiratory volume in 1 second (FEV 1) \< 60% of predicted value (obstructive disease), vital capacity (VC) or total lung capacity (TLC) \< 70% predicted value (restrictive disease).37 * History of contralateral hemidiaphragmatic dysfunction (e.g., paralysis) or phrenic nerve injury. 7. Contraindication to a regional anesthesia technique (e.g., preexisting neuropathy+ in the operative extremity, coagulopathy, sepsis, infection at site of injection, uncooperative, refusal, anticoagulation medications not held within appropriate time frame per American Society of Regional Anesthesia (ASRA) guidelines. 8. Previous contralateral total shoulder replacement managed with regional anesthetic nerve block or periarticular injection/intraarticular injection within the previous 12 months. 9. Known to be currently pregnant or actively breastfeeding++ • ++ Patients that have a previous history of menopause, hysterectomy, or tubal ligation will not be required to perform a pregnancy test. 10. Impaired cognition