Study finds, Mepivacaine for Spinal Anesthesia showed more s
In joint arthroplasty, mepivacaine spinal anesthetic may facilitate a faster postoperative recovery than bupivacaine. The two anesthetics were compared in anterior-approach total hip arthroplasty (THA) at a free-standing ambulatory surgery center -ASC for recovery, discomfort, and complications.

This retrospective cohort study of 282 consecutive patients who underwent THA at an ASC that compares mepivacaine (n=141) versus bupivacaine (n=141) spinal anesthesia, a transition made in March 2019. The main outcomes were length of stay in the postoperative unit (PACU) prior to same-day discharge (SDD), time to controlled void and ambulation. Secondarily, postoperative pain scores (0-10) with morphine equivalents required and any postoperative complications were compared.

--Mepivacaine decreased mean PACU stay (4.0 versus 5.7 hours), time to void (3.1 versus 4.9 hours) and ambulation (3.2 versus 4.5 hours).

--No patients needed urinary catheterization or overnight stay.

--2 patients in the bupivacaine group had transient neurologic symptoms, consisting of foot drop and spinal headache, compared to none with mepivacaine.

--Mepivacaine patients had increased postoperative pain at 2 hours (1.7 versus 0.9), at discharge (1.1 versus 0.5) and morphine equivalent doses received (7.8mg versus 3.7mg).

When compared to bupivacaine, mepivacaine spinal anesthetic for anterior-approach THA safely promoted faster SDD from the ASC by reducing periods to controlled void and ambulation with only a slight increase in discomfort.