LipidRescue™ Resuscitation

We work with a surgeon who requests that his TKA patients receive a preop femoral nerve block (usually with 40cc of ropivicaine 0.5%), spinal (usually with bupivicaine 15mg and Duramorph 400mcg) and then he does an intra-articular injection with ropivicaine 75mg w epi, Duramorph 1mg and ketorolac 75mg just prior to closure. He does not alter the dose for age, size or medical acuity. Also, he often does bilateral knees and in those cases he injects the full intra-articular dose in each knee, doubling this intra-articular dose. Our group has serious concerns about the toxicity of such a practice but have been unable to find studies showing the systemic levels reached with this. Any comments on the safety of this practice?