Effectiveness of Obturator Nerve Block in Preventing Adductor Reflex During Transurethral Resection of Bladder Tumor

Authors

  • Rafia Tabassum Department of Anesthesiology, SICU & Pain Center Peoples University of Medical & Health Sciences for Women (PUMHSW), Shaheed Benazirabad, Sindh, Pakistan
  • Muhammad Saleh Khaskheli Department of Anesthesiology, SICU & Pain Center Peoples University of Medical & Health Sciences for Women (PUMHSW), Shaheed Benazirabad, Sindh, Pakistan
  • Aijaz Hussain Awan Department of Anesthesiology, SICU & Pain Center Peoples University of Medical & Health Sciences for Women (PUMHSW), Shaheed Benazirabad, Sindh, Pakistan
  • Narendar Kumar Department of Pharmacy Practice, Faculty of Pharmacy, University of Sindh, Jamshoro, Pakistan
  • Muhammad Naeem Department of Anesthesiology, SICU & Pain Center Peoples University of Medical & Health Sciences for Women (PUMHSW), Shaheed Benazirabad, Sindh, Pakistan
  • Tahmina Karim Bhatti Department of Anesthesiology, SICU & Pain Center Peoples University of Medical & Health Sciences for Women (PUMHSW), Shaheed Benazirabad, Sindh, Pakistan
  • Razia Sultana Institute of Pharmaceutical Sciences, Peoples University of Medical & Health Sciences for Women (PUMHSW), Shaheed Benazirabad, Sindh, Pakistan
  • Zeeshan Ahmed Department of Pharmacy, Iqra University, Karachi, Pakistan
  • Shaib Muhammad Department of Pharmaceutics, Faculty of Pharmacy, University of Sindh, Jamshoro, Pakistan

Keywords:

Bladder cancer, Obturator nerve, Transurethral resection, Spinal anesthesia, Adductor jerk, Nerve stimulator

Abstract

Background: Bladder cancer is ranked as the 9th most widely diagnosed carcinoma around the globe. Transurethral Resection of Bladder tumor (TURBT) and Cystectomy are the two surgery options, the former being commonly used to diagnose, stage, and treat this cancer. Bladder perforation due to adductor jerk, caused by obturator nerve stimulation, is the major problem encountered during TURBT. Thus, to overcome this situation, an obturator nerve block is performed along with spinal anesthesia (SA).

Objective: The effectiveness of obturator nerve block (ONB) along with spinal anesthesia during TURBT.

Methodology. A prospective study cross-sectional study was conducted from May 2020 to April 2022 at a tertiary care hospital in Sindh, Pakistan. A total of 115 participants were enrolled in the study by convenience sampling and planned to undergo TURBT. A pre-designed proforma was used for data collection. After coding and entering through SPSS 24, the data was analyzed.

Results: The results showed that bladder cancer was more prevalent in males (62.6%) and aged 61-70 years (31.3%). The majority of patients belonged to ASA II (62.6 %). Most patients (94.8%) received blocks in a supine position, with a tumor-sized 2-5cm (81.9%) and located mainly on the right side (70.4%). The effectiveness of ONB reported was (96.5%); however, some cases (3.5%) required general anesthesia (GA) to abolish adductor jerk.

Conclusion: ONB and spinal anesthesia proved to be safe and effective measures for minimizing complications encountered during TURBT.

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Published

2024-01-17

Issue

Vol. 1 No. 4 (2023): Volume 1 (4) 2023

Section

Articles