{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T12:15:26Z","timestamp":1763036126632},"reference-count":18,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2004,11,22]],"date-time":"2004-11-22T00:00:00Z","timestamp":1101081600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2005,1]]},"abstract":"<jats:p><jats:bold>Background:\u2002<\/jats:bold> We tested the hypothesis that selective spinal anesthesia for ambulatory knee arthroscopy can be accomplished with a small dose of bupivacaine at the L3\/4 interspace with or without a head\u2010down tilt of 5\u00b0 when the patients were in the lateral decubitus position.<\/jats:p><jats:p><jats:bold>Methods:\u2002<\/jats:bold> In this double\u2010blind study, 123 patients were randomly allocated to receive spinal anesthesia with 4\u2003mg of hyperbaric bupivacaine inserted at either the L2\/3 interspace, while the vertebral column was kept horizontal (L2\/3 group), or the L3\/4 level, with the vertebral column horizontal (L3\/4H) or tilted 5\u00b0 head\u2010down (L3\/4T). At 7\u2003min, an additional head down tilt was used in all groups if the sensory block was inadequate.<\/jats:p><jats:p><jats:bold>Results:\u2002<\/jats:bold> In the L3\/4T group the sensory block (Th8) reached a significantly higher level 30\u2003min after spinal injection, compared with both the L2\/3 (Th10) and L3\/4H (Th11) groups. In the L3\/4H group, 39% of the patients needed an additional tilt for 3\u2003min at 7\u2003min, compared with 10% (<jats:italic>P=<\/jats:italic>0.004) in the L3\/4T group. Sacral block developed later and recovered faster (<jats:italic>P&lt;<\/jats:italic>0.05) in the L3\/4T group compared to the L3\/4H group. Home\u2010readiness was achieved equally fast in all groups.<\/jats:p><jats:p><jats:bold>Conclusion:\u2002<\/jats:bold> When producing selective spinal anesthesia, the posture of the vertebral column is a major determinant of both sensory and motor segments to be blocked. A 4\u2010mg dose of hyperbaric bupivacaine at the L3\/4 interspace with a 5\u00b0 head\u2010down tilt of the vertebral column for 6\u2003min is recommended for knee arthroscopy.<\/jats:p>","DOI":"10.1111\/j.1399-6576.2004.00533.x","type":"journal-article","created":{"date-parts":[[2006,4,18]],"date-time":"2006-04-18T07:38:30Z","timestamp":1145345910000},"page":"72-77","source":"Crossref","is-referenced-by-count":21,"title":["Influence of the injection site (L2\/3 or L3\/4) and the posture of the vertebral column on selective spinal anesthesia for ambulatory knee arthroscopy"],"prefix":"10.1111","volume":"49","author":[{"given":"A\u2010M.","family":"Korhonen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. V.","family":"Valanne","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R. M.","family":"Jokela","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.","family":"Ravaska","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.","family":"Volmanen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K.","family":"Korttila","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2005,1,26]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF03019208"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/00001503-199810000-00011"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/62.4.358"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000539-200112000-00005"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-6576.2003.00092.x"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2044.2001.01422.x"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2044.2000.01547-4.x"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200312000-00018"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF03016692"},{"key":"e_1_2_6_11_2","volume-title":"Statistics with Confidence","author":"Altman DG","year":"2000"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-196101000-00014"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1399-6576.2003.00206.x"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000539-199808000-00022"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-6576.2003.470103.x"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200208000-00005"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1213\/00000539-199709000-00014"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003643-200210000-00002"},{"key":"e_1_2_6_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199807010-00005"}],"container-title":["Acta Anaesthesiologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1399-6576.2004.00533.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.1399-6576.2004.00533.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,9]],"date-time":"2023-10-09T16:51:51Z","timestamp":1696870311000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1399-6576.2004.00533.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2005,1]]},"references-count":18,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2005,1]]}},"alternative-id":["10.1111\/j.1399-6576.2004.00533.x"],"URL":"https:\/\/doi.org\/10.1111\/j.1399-6576.2004.00533.x","archive":["Portico"],"relation":{},"ISSN":["0001-5172","1399-6576"],"issn-type":[{"value":"0001-5172","type":"print"},{"value":"1399-6576","type":"electronic"}],"subject":[],"published":{"date-parts":[[2005,1]]}}}