Total hip-Position patient lateral, affected hip up. O2 via simple mask, Versed 2mg, Fent 50mcg. Pulse-ox, bp cuff on. Bup. 1/2% preservative free, no dextrose 12.5mg + 0.25mg duramorph 0.5mg/ml (3ml total). 22ga quincke for the old folks (when is the last time you had to patch an old bird for a HA? I never have.) Tell the circulator to start prepping the hip. Propofol gtt 50mcg/kg/min- titrate as needed. Spinals work just as well on young folks- just make sure to use the 25ga whitacre. I used to do sufenta spinals for my ESWLs, but found deep sedation with propofol +/- LMA saves time and is just as effective.