Mepivacaine and bupivacaine spinal comparisons for motor function return, discharge time, and transient neurologic symptoms: An evidence based practice analysis

Abstract

Bupivacaine is the most common local anesthetic used in spinals for total knee arthroplasty (TKA) and total hip arthroplasty (THA) procedures, despite its extended duration (3-9 hours). Most TKA's can be completed in approximately 60-90 minutes and most THAs in 60-120 minutes. This leaves TKA and THA patients largely immobile for much longer than needed when the spinal anesthesia duration exceeds surgical time. Prolonged immobility leads to longer time in PACU, slower discharge times, and increased cost. Mepivacaine may be an excellent alternative for these ambulatory procedures, due to its more reasonable duration of 90-150 minutes, but most providers fear using it due to its association with transient neurologic symptoms (TNS). The purpose of this project is to determine if Mepivacaine is superior to Bupivacaine in terms of motor recovery, earlier discharge, and to examine the incidence of TNS with Mepivacaine use.

Authors

Grant M. Backman

Author Details

Grant M. Backman, DNAP, CRNA

Sigma Membership

Non-member

Type

DNP Capstone Project

Format Type

Text-based Document

Study Design/Type

Other

Research Approach

Translational Research/Evidence-based Practice

Keywords:

Mepivacaine, Bupivacaine, Neuraxial, Spinal Compressions, Anesthesia, Transient Neurologic Symptoms, Transient Radicular Irritation

Advisor

Pecka, Shannon

Degree

Doctoral-Other

Degree Grantor

Bryan College of Health Sciences

Degree Year

2022

Recommended Citation

Backman, Grant M., "Mepivacaine and bupivacaine spinal comparisons for motor function return, discharge time, and transient neurologic symptoms: An evidence based practice analysis" (2024). Group: Bryan College of Health Sciences Doctor of Nurse Anesthesia Practice (DNAP) Collection. 57.
https://www.sigmarepository.org/group_bryan_dnap/57

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Review Type

Faculty Approved: Degree-based Submission

Acquisition

Proxy-submission

Full Text of Presentation

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