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Open shoulder surgery results in significant postoperative pain, often requiring unanticipated hospital admission for management. Traditional methods of pain control, including narcotics, are often inadequate. Interscalene brachial plexus block provides excellent operative conditions for shoulder surgery and, with appropriate local anesthetics, can provide prolonged postoperative anesthesia. The use of continuous interscalene catheters can extend postoperative anesthesia even further, allowing early effective physiotherapy and facilitating earlier discharge.