Obturator Nerve Block in Transurethral Resection of Bladder Tumor: A Comparative Study by two Techniques
Deepak Sharma1, V P Singh1, Nidhi Agarwal1
1Department of Anesthesiology and Critical Care, Subharti University, Meerut, Uttar Pradesh, India.
Anesthesia, Essays and Researches
|March 17, 2017
Summary
Obturator nerve block (ONB) effectively prevents adductor contractions during transurethral resection of bladder tumor (TURBT) under spinal anesthesia. Nerve locator-guided ONB proved more effective than transvesical techniques for improved tumor resection.
Area of Science:
- Anesthesiology
- Urology
- Surgical Procedures
Background:
- Obturator nerve stimulation is a frequent complication during transurethral resection of bladder tumor (TURBT) under spinal anesthesia.
- This involuntary muscle contraction can impede surgical access and increase complication risks.
Purpose of the Study:
- To compare the efficacy and safety of two obturator nerve block (ONB) techniques during TURBT.
- To evaluate the impact of ONB on surgical outcomes and patient safety.
Main Methods:
- A prospective observational study involving 40 male patients undergoing TURBT under spinal anesthesia.
- Patients were divided into two groups: one received ONB with a nerve locator, the other received transvesical nerve block via cystoscope.
- Primary outcomes included adductor reflex occurrence, tumor resectability, and surgical interruptions; secondary outcomes were transfusion needs and bladder perforation.
Main Results:
- Significant differences were observed between groups regarding adductor reflex intensity and tumor resectability.
- Nerve locator-guided ONB demonstrated superior control over adductor contractions compared to the transvesical approach.
- Bleeding occurred in both groups, and one instance of bladder perforation was recorded.
Conclusions:
- Obturator nerve block is a safe and effective adjunct to spinal anesthesia for TURBT, mitigating adductor contractions.
- Nerve locator-guided ONB is a more effective technique than transvesical nerve block for improving surgical conditions during TURBT.
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