Effect of Ultrasound-guided Obturator Nerve Block on Complications in Transurethral Resection for Bladder Cancer

Abstract

Objective:This study explored the efficiency of obturator nerve block (ONB) along with spinal anesthesia on obturator reflex and related complications during transurethral resections (TUR-B) of bladder tumors on the lateral and inferolateral bladder walls.Materials and Methods:We retrospectively reviewed the medical history of 248 patients having undergone TUR-B operations in our hospital between March 2017 and March 2019. Among them, we recruited the data of only 115 patients with bladder tumors on the lateral and inferolateral walls, according to the pre-operation ultrasound reports. Ultimately, 44 patients who received only spinal anesthesia (group A) and 37 patients who underwent spinal anesthesia combined with ONB (group B) were compared concerning postoperative bleeding, adductor muscle contraction, bladder perforation, reoperation, mortality - morbidity rates, length of hospital stay and conversion rates to general anesthesia.Results:There was no significant difference between the groups in terms of age, gender, American Society of Anesthesiologists, length of hospital stay, postoperative bleeding and mortality (p>0.05). Yet, the incidence of obturator reflex in the group A was found to be significantly higher than in the group B (p<0.001), and major complications such as bladder perforation were not encountered in any of the patients.Conclusion:ONB combined with spinal anesthesia in the operations for lateral and inferolateral bladder wall tumors is an effective method to prevent possible obturator reflex and related complications.

Keywords

• cystoscopic surgery complications
• obturator nerve block
• urinary bladder neoplasms