Obturator Nerve Block for Transurethral Resection of Bladder Tumors

Area of Science:

• Urology
• Anesthesiology
• Surgical Oncology

Background:

• Transurethral resection of bladder tumors (TUR-BT) can trigger the obturator reflex, causing involuntary leg movements.
• This obturator reflex can lead to complications during the surgical procedure.
• Preventing this reflex is crucial for patient safety and surgical success.

Purpose of the Study:

• To evaluate the effectiveness of spinal anesthesia with an obturator nerve block (ONB) versus general anesthesia without muscle relaxants for preventing adductor muscle spasms during TUR-BT.
• To compare patient and surgeon satisfaction and complication rates between the two anesthetic techniques.

Main Methods:

• A prospective observational study involving 40 patients undergoing TUR-BT.
• Patients were divided into two groups: Group I (spinal anesthesia + ONB) and Group II (general anesthesia without neuromuscular relaxant).
• Data collected included block performance time, motor blockade severity, procedure length, surgeon/patient satisfaction, and complication incidence.

Main Results:

• No significant difference in block performance or surgical time between groups.
• Group I (spinal anesthesia + ONB) showed higher patient and surgeon satisfaction.
• No complications such as vascular puncture, hematoma, nerve damage, or visceral injury were reported in either group.

Conclusions:

• Routine use of ONB with spinal or general anesthesia (without neuromuscular blockers) can improve oncological outcomes.
• This combined approach reduces complication rates during TUR-BT.
• It may extend disease-free survival periods for patients.