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Indian Journal of Anesthesia and Analgesia

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A Comparison of Ultrasound Guided Versus Ultrasound with Nerve Stimulation Technique for Obturator Nerve Block in Transurethral Resection of Bladder Tumour

Suman Sahu, Senior Resident, Department of Anesthesia, MGM Medical College, Kamothe, Navi Mumbai, Maharashtra 410209, India. , Olvyna D’souza1 , Suman Sahu2 , Supriya Gokhale3 , Deepika Sath4 , Samrajni Ganguly5 Dheeraj Shamsukha6

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Indian Journal of Anesthesia and Analgesia 5(4):p 592-596, April 2018. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5418.14

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Abstract

Introduction: The aim of the study was to compare the effectiveness of two different techniques in blocking obturator nerve (ON) and adductor spasm during transurethral resection of bladder tumor (TURBT).

Methodology: We designed a prospective, randomized, doubleblind study, in which fifty patients with American Society of Anesthesiologists Status II and III were scheduled to undergo TURBT for lateral and posterolateral bladder wall tumor was. Group I (ultrasound only group, n = 25) patients received 4 ml of bupivacaine 0.5% each at anterior, and posterior division of ON under realtime US visualization and Group II (ultrasoundnerve stimulation group, n = 25) received the same amount of bupivacaine 0.5% for each division using USguidance with nerve stimulationassisted technique. Block success and performance time and complications were measured along with patient and surgeon satisfaction into two groups. We did two sample independent ttest and Pearson’s Chisquare/ Fisher’s exact test.

Results: A success rate of 88% was achieved in Group II as compared to 70% in Group I with increased block performance time in Group II (5min) versus (3 min) in Group I. A better patient and surgeon satisfaction were seen in Group II with combination of US and nerve stimulation technique. No complications were encountered.

Conclusion: We conclude that both techniques are safe and easy to perform; however, nerve stimulation along with US results in a higher success rate.

 

 

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5418.14

Keywords

Nerve Stimulation; Obturator Nerve Block; Obturator Reflex; Ultrasound. 

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