Lower local anesthetic concentration and rebound shoulder pain after shoulder arthroplasty

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This randomized, phase 4 trial compares different concentrations of local anesthetic delivered via brachial plexus block for adults undergoing anatomic or reverse total shoulder arthroplasty. The goal is to see if a lower concentration leads to lower rebound pain scores at 24 hours postoperatively. Bupivacaine is the local anesthetic used, and participants are assigned to different concentration levels. Primary care sites are limited to UVA Health, with broad eligibility for adults without certain chronic pain conditions or respiratory issues. The study aims to inform optimal dosing to balance analgesia with rebound pain risk.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* Total shoulder replacement patients (anatomic and reverse)
* Adult patients (greater than or equal to 18 years)
* Any gender
* Any race

Exclusion Criteria:

* \- Chronic Pain diagnoses including:
* substance/opioid use disorder
* complex regional pain syndromes
* fibromyalgia
* Daily persistent opioid use spanning 3 months prior to surgery date
* Allergy to local anesthetics or NSAIDS
* Respiratory pathologies including:
* CPAP- non-compliant / untreated obstructive sleep apnea
* COPD
* Restrictive lung disease (pulmonary fibrosis, interstitial pneumonia, etc)
* Contralateral diaphragm dysfunction
* BMI \> 40
* Ipsilateral extremity pre-existing nerve injury
* GFR \< 60
* NSAID contraindications
* Inability to follow up
* Revision surgery
* Patients requesting block as primary (avoidance of general anesthesia)
* Need or request for brachial plexus catheter or liposomal bupivacaine
* Vulnerable populations (pregnancy, incarceration, etc)
* non-English speaking

Where it's running

• UVA Health
  Charlottesville, Virginia, United States Recruiting

Study contacts

• Principal investigator: Leon N Grinman, DO — Uva
• Study coordinator: Leon N Grinman, DO
• Email: Lngrinman@gmail.com
• Phone: 434-924-3627

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.