Trial reportBMC anesthesiology2025
Comparison of anesthetic effects of spinal anesthesia at L5-S1 and L3-4 under real-time ultrasound guidance in total knee arthroplasty: a single center randomized controlled trial.
Trial report in BMC anesthesiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- When the usual spaces fail: the role of L5-S1 spinal anesthesia in the difficult spine.Korean journal of anesthesiology · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
Abstract
backgroundSpinal anesthesia at L5-S1 is rarely used and many characteristics of L5-S1 spinal anesthesia are not well-documented in the literature. Objective：The primary outcome measure was to compare the highest sensory block level between ultrasound guided L3-4 and L5-S1 spinal anesthesia. Secondary outcomes were the time required to reach the highest sensory block level, the incisional sensory block recovery time, the mean arterial pressure (MAP), heart rate and their changes at each time point during the operation, the operative time, the satisfaction rate of anesthesia, the use of vasopressors, and the incidence of post-operative complications.
methods46 patients who underwent total knee arthroplasty from December 2023 to December 2024 were randomly divided into L5-S1 (group A) and L3-4 (group B) with 23 cases each. In statistical analysis, 41 cases were used. 2 patients were excluded due to missing data in group A. In group B, 1 patient was converted to general anesthesia due to inability to perform spinal puncture because of difficult anatomy, 1 patient received excessive local anesthetic injection at the surgical site, and 1 patient had missing data. All patients were treated with paramedian approach spinal anesthesia under in-plane real-time ultrasound guidance. After successful puncture, 15mg of 0.75% bupivacaine (0.75% bupivacaine 2ml + cerebrospinal fluid 1ml) was injected. A third party recorded all primary and secondary outcomes.
resultsIn the L5-S1 group, the highest sensory block level was lower and the total number of spinal segments blocked were fewer, the time to reach highest sensory block level was longer, and the recovery time of incisional sensory block was longer (P < 0.001). The decrease in MAP was smaller, and the use of vasopressors was less frequent (P < 0.05), with greater hemodynamic stability in the L5-S1 group. The satisfaction rate of anesthesia in both groups was 100%.
conclusionUnder real-time ultrasound guidance, L5-S1spinal anesthesia has many benefits compared to L3-L4 spinal anesthesia.
trial registrationThis trial was registered on July 21, 2025 at the Chinese Clinical Trial center (No. ChiCTR2500106275). Retrospectively registered.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.