Anesthesia & Clinical Research
Open Access

Abstract

A Prospective Randomised Controlled Trial, Comparison of Two Techniques of Obturator Nerve Block during Transurethral Resection of Bladder Tumour (TURBT)

Rahul Gupta*

Background and aims: Obturator nerve traverses close to the posterolateral surface of urinary bladder during its course in the pelvis. During Transurethral Resection of Bladder Tumour (TURBT), its stimulation leads to obturator jerk due to contraction of the muscles of the medial compartment of the thigh. Obturator jerk is a risk factor for bladder wall perforation and may even lead to injury to surrounding pelvic vessels. Obturator nerve block prevents the stimulation of nerve during TURBT. We designed this study to compare two techniques of obturator nerve blocks i.e., landmark guided inguinal technique and transvesical technique to determine the efficacy of obturator nerve block during transurethral resection of bladder tumour.

Method: This randomised, single-blind controlled trial was conducted after ethical approval in patients with lateral or posterolateral urinary bladder mass, with American society of anesthesiologists physical status II and III after obtaining consent. Group T received transvesical and the group I received inguinal obturator nerve block with 15 ml of 0.5% bupivacaine. Each group enrolled 50 participants, 40 males and 10 females. Results: In group T, the adductor jerk occurred in 6 out of 50 cases (12%), whereas in the group I, obturator jerk occurred in 14 out of 50 cases (28%). The difference was statistically significant (P-value 0.046). There were no complications in both groups. One patient in group T required conversion to general anaesthesia.

Conclusion: Our study concludes that during transurethral resection of bladder tumours, the obturator nerve block by transvesical approach is more effective than by the inguinal approach.

Published Date: 2025-01-16; Received Date: 2024-07-02