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Related Experiment Videos

Transurethral surgery and the adductor spasm.

E L Ong1, S T Chan

  • 1Department of Anaesthesia & Surgical Intensive Care, Changi General Hospital, Singapore.

Annals of the Academy of Medicine, Singapore
|July 15, 2000
PubMed
Summary

Adductor spasm during transurethral surgery can cause complications. Local blockade of the obturator nerve is the most effective method to prevent this issue, especially when guided by a nerve stimulator.

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Area of Science:

  • Urology
  • Anesthesiology

Background:

  • Transurethral surgery is a primary treatment for bladder and prostate tumors.
  • Regional anesthesia is preferred, but adductor spasm is a common complication, potentially leading to bladder perforation and increased morbidity.

Purpose of the Study:

  • To review the causes and risk factors of adductor spasm during transurethral surgery.
  • To outline and evaluate techniques for preventing this complication.

Main Methods:

  • A literature search was conducted using PubMed, focusing on studies from 1965 onwards.
  • Studies related to obturator nerve stimulation or adductor spasm in transurethral surgery were selected.

Main Results:

  • Various preventive methods were identified, including local obturator nerve blockade, lignocaine infiltration, adjusting electrode placement, reducing electrocoagulation voltage, and using general anesthesia with muscle relaxants.

Conclusions:

  • Local blockade of the obturator nerve, via direct or "3-in-1" methods, is the most effective strategy.
  • Utilizing a nerve stimulator enhances accuracy and allows for smaller local anesthetic volumes, improving block safety.

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