Date of Award

Spring 4-11-2025

Document Type

Project

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

Advisor

Dr. Brian Garrett

First Committee Member

Dr. Danielle Winch

Second Committee Member

Dr. Amy Bishop

Third Committee Member

Dr. John Chovan

Keywords

Total knee arthroplasty, Spinal anesthesia, Mepivacaine, Neurologic recovery, Postoperative urinary retention, Length of stay

Subject Categories

Medicine and Health Sciences

Abstract

Total knee arthroplasty (TKA) is becoming increasingly prevalent, with projections of a significant rise in cases by 2050. Optimal perioperative management is essential for enhancing postoperative recovery, minimizing complications, and supporting early discharge. Spinal anesthesia, particularly with long-acting agents like bupivacaine, is commonly used; however, it may lead to prolonged motor blockade and postoperative urinary retention (POUR), impacting recovery. Recent research suggests that mepivacaine, an intermediate-acting spinal anesthetic, may offer improved recovery outcomes for TKA patients compared to bupivacaine. This evidence-based practice project aims to evaluate the effectiveness of mepivacaine in reducing neurologic recovery time, POUR, and length of stay (LOS) in TKA patients. The proposed project team will collect data from electronic medical records for the previously mentioned metrics and compare the mepivacaine and bupivacaine groups. Descriptive and inferential statistics will assess differences, with successful outcomes marked by significant improvements in each metric. The findings are expected to demonstrate that mepivacaine allows for faster neurologic recovery and earlier discharge readiness, enhancing patient satisfaction, optimizing hospital resource use, and promoting cost-effective care. These results will influence anesthesia protocols for TKA, supporting the adoption of mepivacaine as the preferred option to improve perioperative outcomes.

Acknowledgement 2

1

Licensing Permission

Copyright, all rights reserved. Fair Use

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