{
  "abstract": "Previous research has shown that spinal mepivacaine can facilitate faster motor recovery and support same-day discharge compared with bupivacaine after hip arthroplasty. However, differences in motor function recovery times between knee and hip arthroplasty have been noted, and same-day discharge rates specifically for knee arthroplasty remain underexplored. This randomized clinical trial 1 compared the effects of spinal anesthesia with 60 mg mepivacaine versus 10 mg isobaric bupivacaine in patients undergoing knee arthroplasty. Spinal mepivacaine was associated with a statistically faster return of motor function compared with spinal bupivacaine (median 210 min vs 229 min, respectively, p<0.001), but this did not translate into a clinically significant advantage. Spinal mepivacaine administration was also associated with lower rates of urinary retention (36% vs 57%, respectively, p=0.007). Time to first ambulation and same-day discharge rates were similar between groups. Although patients who received spinal mepivacaine reported higher pain scores at rest immediately postoperatively compared with those who received spinal bupivacaine (32.4 mm vs 9.5 mm, p<0.001), pain scores at rest at other time points (6, 24, and 48 hours postoperatively), opioid consumption, and other outcomes such as length of stay and side effects were comparable. These findings suggest that low-dose intrathecal bupivacaine may be a reasonable alternative to mepivacaine for facilitating same-day discharge in patients who undergo knee arthroplasty.",
  "authors": [
    {
      "affiliations": [
        "Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "Ryan S D’Souza"
    },
    {
      "affiliations": [
        "Department of Anesthesia and Perioperative Medicine, Medical University of South Carolina, Charleston, South Carolina, USA"
      ],
      "name": "Clinton F Pillow"
    },
    {
      "affiliations": [
        "Department of Anesthesiology, Duke University, Durham, North Carolina, USA"
      ],
      "name": "Sara Amaral"
    }
  ],
  "title": "Spinal anesthesia with mepivacaine versus bupivacaine: early start, same finish—an infographic",
  "uid": "3b80cef8-ad0f-5580-9821-8323cb21f571"
}