Inclusion Criteria:  ASA I-III Age between 18 and 80 Isolated Proximal humeral fracture (AO Types 31.A1-3 and B1-3 or Neer 2/3 part or greater tuberosity fracture equivalent) Locking Plate fixation Split deltoid minimal invasive approach  Exclusion Criteria:  Revision surgery Impaired cognitive function (Abbreviated Mental Test Score (AMT score) < 8) 4 part fractures Poor surgical reduction quality Unable to attend rehabilitation Preexisting shoulder problems Fracture fixation stability unable to tolerate early passive motion exercise Use of implants other than a locking plate for fracture fixation Activity of daily living is dependent on others Polytrauma Use of deltopectoral approach Patient unable to follow post-operative rehabilitation protocol with early mobilization Allergy to amide local anaesthetics, paracetamol, non-steroidal anti-inflammatory drugs (NSAIDS), opioids Respiratory Disease with limited respiratory reserve Cardiac Disease: Any degree of Heart Block, Heart Failure Neurological: Any Seizure Disorder Psychiatric illnesses affecting pain perception e.g. severe depression and anxiety disorder Alcohol or substance abuse Chronic Pain, other than chronic knee pain Daily use of strong opioids (morphine, fentanyl, hydromorphone, ketobemidone, methadone, nicomorphine, oxycodone, or meperidine) Impaired Renal Function (defined as preoperative eGFR < 30ml /min /1.73 m2) Impaired Hepatic Function Pregnancy Inability to use PCA Patient refusal to ISB Patient refusal to study Patients do not understand Cantonese