Shoulder surgery can be performed with general anesthesia, regional anesthesia, or both. These operations include total shoulder arthroplasty, anterior acromioplasty, rotator cuff repair, and repair of humeral or clavicular fractures. Surgery may be performed via an arthroscopic or open approach. Elderly, frail and high-risk patients especially may benefit from regional anesthesia, when administered solely or as adjunct to general anesthesia.