 Known allergy to amide local anesthetics Unstable cardiac arrhythmia Hepatic impairment including but not limited to patients under the care of their physician for severe hepatic disease, cirrhosis or hepatic cancer Known pregnancy at time of surgery pregnancy test morning of surgery if applicable Regular use of narcotic pain medication, defined as use on most days of week at any time in the three months prior to surgery Significant history of opioid or alcohol abuse or addiction requiring treatment Concurrent pain management requiring the use of epidural anesthesia 