Life-threatening haemorrhage following obturator artery injury during transurethral bladder surgery: a sequel of an unsuccessful obturator nerve block

Background. When an obturator nerve block (ONB) is performed, the conventional landmark method or ultrasound-guided method is used. The major complications of this block are hematoma, but there are very few reports of its complications. We encountered massive bleeding and a huge hematoma after ONB. Case Presentation. A 95-year-old female underwent transurethral resection of the bladder tumor. Induction of anesthesia was accomplished via spinal anesthesia and right ONB using the landmark method. Postoperatively, subcutaneous bleeding was detected in the lower right interior thigh. Concentrated red cell transfusion was conducted to address the anemia. There was no subsequent expansion of the hematoma. It resolved on postoperative day (POD) 53. The hematoma was deemed to be inadvertently introduced due to an obturator artery puncture during the obturator nerve block. Conclusions. Close attention is necessary to avoid advancing the needle too deep into the obturator during obturator nerve block.

Download Full-text

Faculty Opinions recommendation of Ultrasound-guided obturator nerve block: interfascial injection versus a neurostimulation-assisted technique.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.721308378.793513261 ◽

2016 ◽

Author(s):

Andrea Fanelli

Keyword(s):

Nerve Block ◽

Obturator Nerve ◽

Ultrasound Guided ◽

Obturator Nerve Block

Download Full-text

Accurate obturator nerve block in transurethral surgery

Urology ◽

10.1016/0090-4295(85)90371-1 ◽

1985 ◽

Vol 26 (6) ◽

pp. 588-589 ◽

Cited By ~ 3

Author(s):

Tsunetada Yazaki ◽

Hiromichi Ishikawa ◽

Shori Kanoh ◽

Kenkichi Koiso

Keyword(s):

Nerve Block ◽

Obturator Nerve ◽

Obturator Nerve Block

Download Full-text

Obturator Nerve Block: From Anatomy to Ultrasound Guidance

Anesthesia & Analgesia ◽

10.1213/01.ane.0000297273.38071.45 ◽

2008 ◽

Vol 106 (1) ◽

pp. 350-351 ◽

Cited By ~ 2

Author(s):

Yoshihiro Fujiwara ◽

Yutaka Sato ◽

Masato Kitayama ◽

Yasuyuki Shibata ◽

Toru Komatsu ◽

...

Keyword(s):

Nerve Block ◽

Ultrasound Guidance ◽

Obturator Nerve ◽

Obturator Nerve Block

Download Full-text

The Effect Of Obturator Nerve Block On Complications During Transurethral Resection Of Lateral Wall Located Bladder Tumours

The Journal of Tepecik Education and Research Hospital ◽

10.5222/terh.2011.38283 ◽

2011 ◽

Vol 21 (3) ◽

pp. 129-133

Author(s):

Zeki Tuncel Tekgül ◽

Rauf Taner Divrik ◽

Murat Turan ◽

Esen Şimşek ◽

Ersin Konyalıoğlu ◽

...

Keyword(s):

Nerve Block ◽

Transurethral Resection ◽

Lateral Wall ◽

Obturator Nerve ◽

Obturator Nerve Block ◽

Bladder Tumours

Download Full-text

OBTURATOR NERVE RLOCK

The Professional Medical Journal ◽

10.29309/tpmj/2009.16.01.2972 ◽

2009 ◽

Vol 16 (01) ◽

pp. 48-52

Author(s):

NASEEM AHMED ◽

Shahid Mahmood Rana ◽

SYED MUHAMMAD ZAHEER HAIDER ◽

Arshad Mahmood ◽

FAIZAN AHMED ◽

...

Keyword(s):

Nerve Block ◽

Spinal Anaesthesia ◽

Bladder Wall ◽

Obturator Nerve ◽

Physical Status ◽

Effective Technique ◽

Obturator Nerve Block ◽

Partial Suppression ◽

A Prospective Study ◽

Study Setting

Objectives: To evaluate the efficacy of obturator nerve block combined with spinal anaesthesia for prevention of adductormuscle spasm and its associated complications during transurethral resection of bladder tumours located at its lateral and inferolateral wall.Study design: A prospective study. Setting: At AFIU Rawalpindi. Period: From January 2005 to December 2006. Material and methodFifty patients who had tumours at their lateral / inferolateral bladder wall of physical status ASA I - IV received spinal anaesthesia at 3r d or4l h lumbar space followed by obturator nerve block with a view to preventing adductor jerk during resection of tumour. Results: There wascomplete suppression of adductor jerk in 45 (90%) patients and surgery was completed smoothly. Two patients (4%) had mild adductorjerk and additional sedation was required. The block failed to work in 3 (6%) cases and required conversion to general anaesthesia. Thusthe procedure was successful in 94% (complete and partial suppression of jerk. Conclusion: We conclude that spinal anaesthesiacombined with obturator nerve block is an effective technique for preventing adductor jerk during TUR-BT, thus avoiding intra-operative andpost operative complication.

Download Full-text

Obturator nerve block

Regional Anesthesia and Acute Pain Management ◽

10.17816/1993-6508-2020-14-3-130-140 ◽

2021 ◽

Vol 14 (3) ◽

pp. 130-140

Author(s):

V. A. Koriachkin ◽

D. V. Zabolotskii ◽

D. V. Gribanov ◽

T. A . Antoshkova

Keyword(s):

Clinical Practice ◽

Nerve Block ◽

Lateral Wall ◽

Obturator Nerve ◽

Anatomical Landmarks ◽

Anatomical Features ◽

Obturator Nerve Block ◽

Adductor Muscles ◽

Ultrasonic Navigation ◽

Hip And Knee Surgery

One of the forgotten techniques of regional anesthesia is blockade of the obturator nerve, which was performed using anatomical landmarks and neurostimulation. In recent years, ultrasonic navigation methods have gained wide popularity when using regional blockades. The purpose of the review is to present the current understanding of the use of obturator nerve block in clinical practice. The review presents the anatomical features of the obturator nerve passage, surgical and therapeutic indications for the use of its blockade. The technique for performing obturator blockade using ultrasound navigation is described in detail. Blockade of the obturator nerve using ultrasound navigation can reduce the likelihood of surgical complications during transurethral resection of a tumor located on the lateral wall of the bladder, improve analgesia after hip and knee surgery, and effectively relieve spastic conditions of the adductor muscles of the hip.

Download Full-text