Spinal or epidural - these are very good considerations for these cases as they been shown to provide both analgesia and reduce blood loss. For spinals, the addition of lidocaine (10 mg), epinephrine (15 mcg), and fentanyl (25 mcg) has been shown to be very effective at both reducing postoperative pain and discharge times. Blood loss - You may be asked by physician to keep blood pressures low to reduce blood loss (Systolic ~ 90-110). TXA - Anticipate administration of tranexamic acid (TXA). Timing for administration of TXA is highly variable, so ask for the preference of the surgeon. Bone cement - Anticipate the use of bone cement and prepare for bone cement implantation syndrome (this syndrome primarily causes hypoxia and hypotension).
