scholarly journals Fuzzy C-Means Algorithm-Based Adoption of Obturator Nerve Block under Adaptive Ultrasound Imaging for Bladder Tumor

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Jianyun Hu ◽  
Pinglin He ◽  
Bixin Zhang ◽  
Bin Su ◽  
Jing Chen ◽  
...  
Keyword(s):  
Ultrasound Imaging ◽  
Nerve Block ◽  
Epidural Anesthesia ◽  
Bladder Tumor ◽  
Obturator Nerve ◽  
Medical Ultrasound ◽  
Bladder Tumors ◽  
Medical Ultrasound Imaging ◽  
Obturator Nerve Block ◽  
Group A

This work aimed to study the adoption of obturator nerve block (ONB) based on adaptive medical ultrasound imaging under C-means algorithm in transurethral resection of bladder tumor (TURBT). 120 patients with bladder tumors were diagnosed by C-means algorithm-based ultrasound imaging and were enrolled into group A (epidural anesthesia + resection), group B (general anesthesia), and group C (epidural anesthesia + ONB), each with 40 cases. The accuracy of the detection method, noise level, and complications before and after the operation were compared. All patients received TURBT for treatment. There was no significant difference in the general information of patients in each group ( P > 0.05 ). As a result, the correct segmentation rate of the tumor region segmented by ultrasound imaging by C-means algorithm reached 95.6%. The incidence of obturator nerve reflex (ONR) in group A (7.5%) was greatly inferior to groups B and C ( P < 0.05 ). The length of hospital stay in group A was (4.01 ± 1.43) days, which was notably different from groups B and C, with considerable difference among the three ( P < 0.05 ). In short, the adaptive medical ultrasound imaging under C-means algorithm was more accurate in the diagnosis of bladder tumors. Moreover, ONB can effectively reduce the ONR and the incidence of complications in patients.

scholarly journals Outcome of Obturator Nerve Block by Inguinal and Transvesical Approach in Transurethral Resection of Bladder Tumor

2020 ◽  
Vol 23 (2) ◽  
pp. 118-123
Author(s):  
Md Mahmud Ur Rahman ◽  
Md Shafiqul Alam Chowdhury ◽  
Md Amanur Rasul ◽  
Sudip Das Gupta ◽  
Mohammed Mizanur Rahman
Keyword(s):  
Nerve Block ◽  
Transurethral Resection ◽  
Bladder Tumor ◽  
Bladder Wall ◽  
Obturator Nerve ◽  
Obturator Nerve Block ◽  
Significant Difference ◽  
Group A ◽  
Transvesical Approach ◽  
Group B

Introduction and aim of the study : Spinal anaesthesia for transurethral resection of bladder tumor (TURBT) does not prevent unintended stimulation of the obturator nerve when electro resection is performed on the lateral and Postero-lateral wall of the bladder. It results in muscle contraction of the adductor muscles of the thigh, which may lead to perforation of bladder wall with the resectoscope loop. The aim of the study was to compare the outcome of obturator nerve block by inguinal and transvesical approach. Materials and Methods: A prospective experimental study was done in the department of Urology Dhaka Medical College Hospital during the period of November 2016 to April 2018. Total 60 Patients were included for the study as per inclusion and exclusion Criteria. Patients were than allocated purposively into two groups by simple random sampling. Group A consisted of 30 patients where obturator nerve block (ONB) was done by transvesical approach and Group B also consisted of 30 patients where ONB was done by inguinal approach. Results: In the present study, the baseline characteristics of the patients in Group-A and Group-B were almost similar having no statistically significant difference. Obturator jerk more frequently occurred in group-B, in 13 (56.37%) patients following TURBT compared to Group-A, where 05(16.67%) patients developed obturator jerk. The intergroup difference was statistically significant (p<0.05). In case of 26 (86.67%) patients tumour was completely resectable in group-A, while in 21 (70.00%) patients of Group- B tumour was completely resectable. This was not a statistically significant difference (P>0.05). There was no incidence of bladder wall perforation in group-A, wherears this complication occurred in 02 (06.67%) cases of Group-B (p>0.05). Mean operative time in Group-A and group-B is 50.46 (±11.64) and 59.10 (±15.83) respectively (p<0.05). Conclusion: We conclude that transvesical approach is better in case of Jerk elimination and Less Procedure related time than inguinal approach during TURBT Bangladesh Journal of Urology, Vol. 23, No. 2, July 2020 p.118-123

scholarly journals Obturator Nerve Block Using Levobupivacaine for the Prevention of Adductor Spasm in Transurethral Bladder Tumor Resection

2013 ◽  
Vol 33 (1) ◽  
pp. 49-53
Author(s):  
Kamil DARÇIN ◽  
Züleyha KAZAK BENGİSUN ◽  
Perihan EKMEKÇİ ◽  
Ahmet Hakan HALİLOĞLU ◽  
Arif Hikmet SÜER
Keyword(s):  
Nerve Block ◽  
Bladder Tumor ◽  
Tumor Resection ◽  
Obturator Nerve ◽  
Obturator Nerve Block

Effectiveness and Safety of a Modified Technique of Transvesical Obturator Nerve Block to Avoid Adductor Contractions during Transurethral Resection of Bladder Tumors

2021 ◽  
pp. 1-9
Author(s):  
Nici Markus Dreger ◽  
Anna Lohbeck ◽  
Stephan Roth ◽  
Daniel Gödde ◽  
Friedrich-Carl von Rundstedt ◽  
...  
Keyword(s):  
Nerve Block ◽  
Transurethral Resection ◽  
Obturator Nerve ◽  
Control Group ◽  
Bladder Tumors ◽  
Modified Technique ◽  
Recurrence Rates ◽  
Obturator Nerve Block ◽  
Significant Difference

<b><i>Introduction:</i></b> The aim of the study was to evaluate the effectiveness of a modified transvesical obturator nerve block (ONB) in the prevention of obturator nerve reflex and consecutive bladder perforations (BPs) during transurethral resection of bladder tumors (TURBTs). <b><i>Materials and Methods:</i></b> A retrospective analysis of all patients resected in 2014–2015 due to a bladder tumor of the lateral walls, including a follow-up period until December 2018, was performed. Two groups were defined: in the first group, all patients underwent TURBT with a modified transvesical ONB. The second group underwent conventional TURBT with intermittent resection. Primary endpoints were the rates of adductor contractions and BPs. <b><i>Results:</i></b> Ninety-four out of 1,145 resected patients presented with tumors on the lateral wall of the bladder and a complete dataset including a long-term follow-up. Thirty-six patients were treated in the ONB group, and 58 patients comprised the control group. The median age in the 2 groups was 70.8 and 71.8 years in the first and second groups, respectively. Adductor spasms were reported in 8.33 versus 25.86% (<i>p</i> = 0.057) and perforation in 2.78 versus 17.24% (<i>p</i> = 0.047) in groups 1 and 2, respectively. After a median follow-up of 32.5 months, there was no significant difference in recurrence rates (52.78 vs. 51.72%, <i>p</i> = 0.672). In a subgroup analysis, lower perforation rates were recorded for the ONB group in patients with tumors &#x3c;3 cm (0/30 vs. 8/46, <i>p</i> = 0.076) and in patients with unifocal tumors (0/12 vs. 5/23, <i>p</i> = 0.141). <b><i>Discussion/Conclusion:</i></b> The simplified approach of transvesical ONB demonstrated in this study appears to be an inexpensive, safe, effective, and simple-to-use technique.

A Comparison Between Blind and Nerve Stimulation Guided Obturator Nerve Block in Transurethral Resection of Bladder Tumor

2012 ◽  
Vol 26 (10) ◽  
pp. 1319-1322 ◽  
Author(s):  
Mohammadhatef Khorrami ◽  
Mazaher Hadi ◽  
Amir Javid ◽  
Mohammad-Hossein Izadpahani ◽  
Mehrad Mohammadi Sichani ◽  
...  
Keyword(s):  
Nerve Block ◽  
Nerve Stimulation ◽  
Transurethral Resection ◽  
Bladder Tumor ◽  
Obturator Nerve ◽  
Obturator Nerve Block
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