scholarly journals Transurethral resection of bladder tumor surgery conducted using epidural anesthesia and obturator nerve block in an elderly multimorbid male

2021 ◽  
Vol 2 (4) ◽  
Author(s):  
Ankita Kabi ◽  
◽  
Rekha Kumari ◽  
Shivanand Bone ◽  
◽  
...  
Keyword(s):  
General Anesthesia ◽  
Nerve Block ◽  
Transurethral Resection ◽  
Early Mobilization ◽  
Early Discharge ◽  
Pulmonary Complications ◽  
Obturator Nerve ◽  
Glottic Carcinoma ◽  
Bladder Tissue ◽  
Obturator Nerve Block

pidural Anesthesia (EA) is mainly used for perioperative and postoperative analgesia, usually combined with Spinal Anesthesia (SA) or General Anesthesia (GA). It is safe, easy to perform, and has multiple applications. The benefits of Regional Anesthesia (RA) over general anesthesia include superior analgesia, reduced opioid consumption, reduced pulmonary complications, improved gastrointestinal function, early mobilization, a reduced need for thrombo-prophylaxis, early discharge, and higher patient satisfaction. Anesthesia for urological surgeries has unique problems due to patient factors and procedure complexity. An 84-year older man with a known history of hypertension/ Coronary Artery Disease (CAD)/ complete Left Bundle Branch Block (LBBB)/ dilated cardiomyopathy/ glottic carcinoma/ mixed airway disease, with an ejection fraction of 30%, was scheduled to undergo Transurethral Resection of Bladder Tissue (TURBT) for carcinoma bladder mass. It was done under EA and an ipsilateral obturator nerve block.

scholarly journals The optimal method of anesthesia for transurethral resection of a lateral bladder wall

2020 ◽  
Vol 14 (2) ◽  
pp. 86-92
Author(s):  
Ivan A. Rychkov
Keyword(s):  
General Anesthesia ◽  
Spinal Anesthesia ◽  
Nerve Block ◽  
Transurethral Resection ◽  
Sinus Bradycardia ◽  
Randomized Study ◽  
Bladder Wall ◽  
Side Wall ◽  
Obturator Nerve ◽  
Obturator Nerve Block

In our prospective randomized study, 130 patients underwent a transurethral resection (TUR) because a neoplasm was located on the side wall of the bladder. In the neurostimulation (NS) group (n = 50), a spinal anesthesia with an obturator nerve block was made under the control of a neurostimulation; in the ultrasound (US) + NS group (n = 50), a spinal anesthesia with an obturator nerve block was made under the double control of ultrasound navigation and neurostimulation; in the general anesthesia (GA) group (n = 30), a general anesthesia with a deep myoplegia was made. Results: The obturator nerve reflex was recorded for three (6%) patients from the NS group (p 0.001); it caused a bladder perforation in one patient. The frequency of a sinus bradycardia in the NS (18%) and US + NS (20%) groups was lower than in the GA (43%) group, p = 0.008. Arterial hypotension was observed only in the OA group for 8 (27%) patients (p 0.001). In the NS and US + NS groups, the patients time in the surgery room was significantly less (p 0.001) than in the OA group averaging 48.36 17.58 min and 50.82 23.6 min, respectively. Conclusion: The combination of a spinal anesthesia with obturator nerve block under the dual control of an ultrasound navigation and a neurostimulation can be considered as a reliable and safe method of an anesthetic maintenance of the TUR on the wall of the bladder. If it is impossible to provide such a control over the implementation of the blockade, it is necessary to resort to a GA with a deep myoplegia.

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

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

scholarly journals MP08-02 COMPARING LIDOCAINE VERSUS MEPIVACAINE IN OBTURATOR NERVE BLOCK FOR TRANSURETHRAL RESECTION OF THE BLADDER

2018 ◽  
Vol 199 (4S) ◽  
Author(s):  
Pascal Viktorin-Baier ◽  
Isabelle Keller ◽  
Barbara Jung ◽  
Michael Ganter ◽  
Hubert John
Keyword(s):  
Nerve Block ◽  
Transurethral 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.

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