We sent questionnaires to 1, 416 registered hospitals of The Japanese Orthopaedic Association and made inquiries about the use of bupivacaine for spinal anesthesia. We received answers from 870 hospitals (reply rate of 61.4%). In 85.7% of these hospitals, orthopaedic surgeons anesthetize their patients, performing surgical operations of their hips or lower extremities. In 41.4% of these hospitals, they use Marcain® for spinal anesthesia. During the 6 month period between January through June of 1998, 39, 690 patients were anesthetized by orthopaedic surgeons in those 870 hospitals. 27, 287 cases were for spinal anesthesia and Marcain spinal were used in 7, 321 cases. The most common side-effects were hypotension, but its degree was mild and controllable. No neurologic side-effects were reported. 90.5% of the surgeons who had experienced the Marcain spinal anesthesia reply that they need preservative-free bupivacaine for spinal anesthesia strongly.
