Obturator Nerve Block in Lithotomy Position to Prevent Adductor Muscle Contraction during Trans-Urethral Resection of Bladder Tumours

Dr. Apurva Rajurkar, Dr. Mansi Swaminarayan, Dr. Neha Ahuja, Dr. Satvikajanarthanam

Abstract: Bladder growth is the most prevalent urological malignancy. It is managed by TURBT. TURBT is often performed with SA, but it cannot block the obturator jerk reflex. So, the technique that proves to be effective for preventing the obturator jerk is ONB following SA. Objective -To assess the efficacy and safety of ONB performed with nerve stimulator using the interadductor approach in the lithotomy position versus the supine position performed under SA. Material And Method-This is prospective, randomised, controlled, interventional, single blind study. Total 50 patients of ASA physical status I, II and III, between 45 and 80 years undergoing TURBT under SA with ONB were randomly allocated to two equal groups Group A Supine Group Block in supine position. Group B Lithotomy Group Block in lithotomy position. After giving SA, ONB was given. Patients were studied for adductor spasm, ease of administration, minimum current and the time required to give the block, and any complications RESULT- Statistically significant occurrence of adductor spasm was noted in Group A compared to Group B (p

Keywords: TURBT- TRANSURETHRAL RESECTION OF BLADDER, ONB- OBTURATOR NERVE BLOCK, SA- SPINAL ANESTHESIA