The goal of this clinical trial is to learn if there is a difference in morphine requirements in patients after upper extremity surgeries including shoulder arthroscopy. The main question it aims to answer is whether there is a difference between Interscalene brachial plexus blocks with the addition of buprenorphine, dexamethasone, and clonidine and the same block without the adjuvant.
Patients ≥ 18 years old
Patients undergoing shoulder arthroscopy
Patients willing to participate and sign informed consent
Severe COPD/other contraindication to general anesthesia
Patient with a weight of less than 60 kg
Dementia, not alert or oriented to person, place, or time
Chronic pain patient with daily opioid use at home.