There is at least one option for patients who don't tolerate general anesthesia. A regional anesthetic called an interscalene block can be done. You would be awake and have complete pain relief during and after the operation. There are some disadvantages and risks, which the doctor will review with you.
One of the main benefits of the block is a reduction of the postoperative nausea that you've experienced in the past. And it offers good pain control after the operation making early movement and return of function possible. Earlier discharge is often possible as well.
Sometimes the block can be left in place during the first day after surgery. The joint is continuously bathed in a numbing agent to extend pain relief during the early recovery phase. Another option for postoperative pain control is a special device called a patient-controlled analgesia. With the push of a button the patient is able to release a dose of pain medication into the blood stream or a numbing agent to the surgical site.
Be sure and raise your questions and concerns with the orthopedic surgeon before surgery. Don't wait until the day of the operation. And when the anesthesiologist meets with you before the operation, express your concerns then as well.