scholarly journals Effectiveness of spinal anesthesia combined with obturator nerve blockade in preventing adductor muscle contraction during transurethral resection of bladder tumor

2017 ◽  
Vol 43 (4) ◽  
pp. 507-511 ◽  
Author(s):  
Cyrus Emir Alavi ◽  
Seyed Alaeddin Asgari ◽  
Siavash Falahatkar ◽  
Siamak Rimaz ◽  
Mohammadreza Naghipour ◽  
...  
Keyword(s):  
Muscle Contraction ◽  
Spinal Anesthesia ◽  
Transurethral Resection ◽  
Bladder Tumor ◽  
Adductor Muscle ◽  
Obturator Nerve ◽  
Nerve Blockade

1042 Transvesical blockade of obturator nerve to prevent adductor muscle contraction during transurethral resection of bladder tumor

2012 ◽  
Vol 11 (1) ◽  
pp. e1042-e1042a
Author(s):  
M.H. Khorrami ◽  
F. Farahini ◽  
M.H. Izadpanahi ◽  
M. Zargham ◽  
M. Mohammadi ◽  
...  
Keyword(s):  
Muscle Contraction ◽  
Transurethral Resection ◽  
Bladder Tumor ◽  
Adductor Muscle ◽  
Obturator Nerve

Comparison of Endoscopic Versus Percutaneous Approach (Blind) to Control the Obturator Jerk in Patients Undergoing Transurethral Resection of Bladder Tumors Under Spinal Anesthesia

2020 ◽  
Vol 21 (2) ◽  
pp. 120-126
Author(s):  
Alamgir Md ◽  
Karim Km Monwarul ◽  
Nandy SP ◽  
Md Monwar Ul Haque ◽  
Sakhawat Mahmud Khan
Keyword(s):  
Statistical Analysis ◽  
Spinal Anesthesia ◽  
Transurethral Resection ◽  
Bladder Tumor ◽  
Complete Resection ◽  
Satisfaction Level ◽  
Bladder Tumors ◽  
Percutaneous Approach ◽  
Group A ◽  
Group B

Objective: The aim of the study was to compare the endoscopic versus percutaneous approach (blind) to control the obturator jerk in patients undergoing transurethral resection of bladder tumors under spinal anesthesia. Materials and methods: A prospective observational study was performed in Department of Urology, Chittagong Medical College, Chittagong and some Private Hospitals (Ltd.) in Chittagong city during the period from January 2016 to June 2016. Total 100 patients were grouped into two, on alternate basis. Fifty(50) patients in group- A conducted with endoscopic infiltration with 20ml of injection 2% lignocaine at the bladder tumor base and another 50 patients in group-B, conducted with blind percutaneous technique with same drug and volume ( 20ml inj.2% lignocaine) to control obturator jerk. Severity of obturator jerk in both procedure, percentage of complete resection, ONB procedure related time, ONB procedure related complications and surgeon’s satisfaction level were recorded and compared between two approaches. Chi-square analysis was performed to compare the ease of approach and outcome of the two techniques. A value of P<0.05 was considered statistically significant. Results: The mean age of the patients were 59.44+7.681. In group-A, 50 patients were given inj. 2% lignocaine endoscopically at the bladder tumor base to control obturator jerk. Twenty five patients (50%) had no jerk, 20 patients(40%) developed mild jerk and 5 patients (10%) developed moderate jerk and no patients developed severe jerk. Second attempt was taken in moderate jerk patients (5 patients) and succeeded in 3(6%) patients. So, in this group, complete resection of bladder tumor was possible in 96%. In group B, complete resection of bladder tumor was possible in 84%. Statistical analysis was done and result is significant in case of endoscopic procedure to control obturator jerk(p<0.05). ONB Procedure related time was <20 mins. in 32(64%) patients in group-A and 45 (90%) patients in group- B. 20 mins. or more time was required for 18 (36%) patients in group-A and 5 (10%) patients in group-B. Statistical analysis was done and result is significant in percutaneous (blind) technique (p<0.05). ONB procedure related complications in group-A and Group –B were noted. Statistical analysis was done and result is insignificant (p>0.05). Surgeons satisfaction level were recorded on the basis of obturator jerk block and complete resection and which was statistically significant in favour of endoscopy group (p<0.05). Conclusion: It is concluded that endoscopic injection of 2% lignocaine into the bladder tumor base is better in case of jerk elimination and complete resection than blind percutaneous approach. Though, ONB procedure related time was significantly less in percutaneous group. Bangladesh Journal of Urology, Vol. 21, No. 2, July 2018 p.120-126

scholarly journals Impact of nerve stimulator-guided obturator nerve block on the short-term outcomes and complications of transurethral resection of bladder tumour: A prospective randomized controlled study

2015 ◽  
Vol 9 (11-12) ◽  
pp. 780 ◽  
Author(s):  
Deniz Bolat ◽  
Ozgu Aydogdu ◽  
Zeki Tuncel Tekgul ◽  
Salih Polat ◽  
Tarik Yonguc ◽  
...  
Keyword(s):  
Spinal Anesthesia ◽  
Bladder Wall ◽  
Lateral Wall ◽  
Adductor Muscle ◽  
Obturator Nerve ◽  
Controlled Study ◽  
Nerve Stimulator ◽  
Short Term ◽  
Randomized Controlled ◽  
Obturator Nerve Block

Introduction: In this prospective randomized controlled study, we investigated the efficacy of obturator nerve block (ONB) on adductor muscle spasm and related short-term outcomes and complications in patients who underwent transurethral resection of lateral wall-located bladder tumours (TURBT).Methods: Between July 2014 and February 2015, 70 patients scheduled to undergo TUR of lateral bladder wall tumours were enrolled in the study. All patients were preoperatively evaluated by cystoscopy and imaging tools and selected according to localized tumours on the lateral bladder wall. Patients were randomly allocated to Group SA (35 patients who underwent only spinal anesthesia) and Group ONB (35 patients who underwent spinal anesthesia combined with ONB by the nerve stimulator). An independent observer, blinded to the approach, evaluated the obturator signs, including adductor muscle contraction, bladder perforation, and completeness of the resection during the TURBT procedure.Results: The differences between groups regarding mean operation time, tumour size, and number were not statistically significant (p > 0.05). Adductor muscle contraction was detected in 40% of patients in Group SA and 11.4% in Group ONB. This difference was statistically significant (p = 0.021). Complete bladder perforation was detected in 2 patients in Group SA, whereas no perforation was observed in Group ONB. There was no case of severe bleeding in both groups. Conclusions: We found that ONB performed after spinal anesthesia was effective in preventing intraoperative complications due to adductor muscle spasm while performing TURBT. Our study limitations include its small sample size, since we only enrolled patients with primary lateral wall-localized bladder tumo

Inadvertent Breakage of the Spinal Needle during the Obturator Nerve Block for the Transurethral Resection of Bladder Tumor - A case report -

2007 ◽  
Vol 53 (2) ◽  
pp. 250 ◽  
Author(s):  
Ji Hyun Chin ◽  
In Gu Jun ◽  
Young Kug Kim ◽  
Keum Nae Kang ◽  
Gyu Sam Hwang ◽  
...  
Keyword(s):  
Case Report ◽  
Nerve Block ◽  
Transurethral Resection ◽  
Bladder Tumor ◽  
Obturator Nerve ◽  
Spinal Needle ◽  
Obturator Nerve Block

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

Sign in / Sign up

Export Citation Format

Share Document