scholarly journals Effect of ultrasound-guided proximal and distal approach for obturator nerve block in transurethral resection of bladder cancer under spinal anesthesia

2019 ◽  
Vol Volume 11 ◽  
pp. 2499-2505
Author(s):  
Chao Han ◽  
Tieliang Ma ◽  
Daoyun Lei ◽  
Songhui Xie ◽  
Zhijun Ge
Keyword(s):  
Bladder Cancer ◽  
Spinal Anesthesia ◽  
Nerve Block ◽  
Transurethral Resection ◽  
Obturator Nerve ◽  
Ultrasound Guided ◽  
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.

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