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

2024-01-17T05:13:27+00:00

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.

Barriers in Evidence Based Nursing Care at Tertiary Care Hospital

2024-03-26T09:04:20+00:00

Background: The integration of evidence-based nursing within clinical settings holds paramount importance. Nurses and midwives have a pivotal role in incorporating current evidence. Nevertheless, the presence of inadequate support and obstacles in applying evidence-based practice obstructs the utilization of modern evidence in making clinical decisions.

Objective: To determine the barriers in evidence-based nursing (EBN) care at tertiary care Hospital

Methodology: This cross-sectional study was conducted at clinical area of Liaquat university of Medical and Health Science, from October 2019 to March 2020. All the registered nurses working at tertiary care Hospital, nurses age of >25 years and nurses willing to participate in the study were included. All participants were interviewed regarding their demographic characteristics as age, educational status, work experience and socioeconomic status. Further these nurses were interviewed regarding barriers in EBN at tertiary care hospital. A self-made questionnaire has been developed to collect the data. All the information was collected on predesigned Performa.

Results: In this study total 184 study participants were studied; the most common age group was 25-35 years. Males were 39.7% and females were 60.3%. 46.2% cases had work experience <5 years, 51.1% had 6- 10 years and 2.7% had work experience of >10 years. According to the barriers in EBN there was lack of human sources, access to internet and rich library, time, knowledge, autonomy change practices, lack ability to hard work, lack incentives and motivation, heavy work load, no cooperation physicians, Individual’s aspects, residential status, patient assessments and from the organization.

Conclusion: It is concluded that, nursing staff are facing different types of difficulties including shortness of nursing staff and other lower staff, autonomy change practices, lack of proper knowledge according to require work, not proper updating programing and lack of incentives, unavailability of internet sources at hostels and Hospitals, many physicians not cooperative and scolding and insulting.

RADS Journal of Pharmacy and Allied Health Sciences

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

Barriers in Evidence Based Nursing Care at Tertiary Care Hospital