Mepivacaine Versus Bupivacaine for Patients Undergoing Total Joint Arthroplasty

Key Message

• Mepivacaine was found to have statistically significantly better results than bupivacaine for various specific measurements related to neurologic symptoms, mobility, length of stay, urinary retention, and adverse events and safety; however, for the overall evidence, the difference in outcomes between the 2 did not consistently reach the level of statistical significance.
• The overall evidence for postoperative pain largely found no statistically significant difference between mepivacaine and bupivacaine, except for proportion of postoperative zero pain, where mepivacaine resulted in a statistically greater proportion of patients reporting zero pain postoperatively than bupivacaine.
• Evidence was only identified for individuals who received either total hip arthroplasty or total knee arthroplasty, and thus the findings presented in this report may not be generalizable to other total joint reconstruction or replacement surgeries.
• No evidence was identified regarding the cost-effectiveness or evidence-based guidelines for the use of mepivacaine versus bupivacaine for total joint arthroplasty.