As found from a recent study published in “The Journal of Shoulder and Elbow Surgery”, the  interscalene nerve block offers improved pain relief immediately after shoulder arthroplasty as evidenced by shorter postanesthesia care unit (PACU) stays, reduced pain scores at six hours postoperatively, and less opioid medication intake during the first 24 hours after surgery when compared to local liposomal bupivacaine. Iman Ali et al. carried out this dual-center randomized controlled trial to compare the analgesic effect of both the procedures in 108 participants (n = 54 each) after shoulder arthroplasty.

Evaluation of visual analog scale (VAS) pain scores was done at six-hour intervals from 6 to 96 hours after surgery and at the first postsurgery visit. The opioid medication intake intrasurgery and at days 1, 2, 3, and 4 postsurgery, and the duration of hospital and PACU stays were also determined.

At six hours after surgery, the mean VAS pain score was reduced in the interscalene nerve block arm compared to the local liposomal bupivacaine arm. In comparison with the local liposomal bupivacaine arm, the interscalene nerve block group consumed less opioid medication during the first 24 hours after surgery and had a shorter PACU stay, as depicted in Table 1:

Thus, interscalene nerve block yields better pain management compared to local liposomal bupivacaine in patients after shoulder arthroplasty. But, no differences in outcomes were witnessed between the groups beyond 24 hours, concluded the study authors.