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It seems to be a matter of local culture. At our institution, we have residents and fellows, we have a regional staff, several staff confident in their regional skills and staff, while not confident in performing the blocks, appreciate their value and ...

We use mepivacaine spinals routinely for our Same Day Discharge and ASC Joint Replacements. We use 39, 42 and 45 mg (2.6 ml, 2.8 ml, 3.0 ml) for our faster surgeons. We go up to 60 mg for our slower surgeons. In our ASC we have 1 very fast surgeon for ...

We use Spinal isobaric mepivacaine routinely for our total joints. We discharge essentially all of our patients same day. We use 40 mg for our faster surgeons , 45-50 for moderate surgeons and 50 to 60 mg for our slower surgeons. We also use 42 mg of ...

At the hospital for special surgery we have been using mepivacaine sinals and CSEs for almost all amb surg cases and the majority of THRs and TKRs for over 20 years. Although a few percent may have mild symptoms c/w TNS, it is almost never clinically ...