AN EFFECTIVE TECHNIQUE OF OBTURATOR NERVE BLOCK TO PREVENT ADDUCTOR REFLEX DURING TRANSURETHRAL RESECTION OF BLADDER TUMOR

Obturator Nerve Block During Transurethral Resection

Abstract

Objective: To observe the efficacy of blind obturator nerve block by Labat technique for prevention of obturator jerk during transurethral resection of bladder tumor performed under spinal anesthesia.
Study Design: Descriptive Study.
Material and Methods: This was a single center based study conducted at tertiary care military hospital for a period of thirty months. Fifty five patients were recruited in the study, after identifying the location of bladder growth in the lateral wall on ultrasound USG and confirming its exact site on cystoscopic examination. Those eliciting obturator jerk during transurethral resection of bladder tumor (TURBT) were included and ONB was performed using 2% lidocaine via blind technique of Labat. TURBT was restarted and presence of obturator jerk was recorded if evoked (primary outcome).
Results: Median age was 67.3 ± 8 years with majority (72.7%) in the age group between 61 to 80 years. Male female ratio was 7:1. Fifty (90%) patients presented with solitary growth. Mean operating time was 28.8 ± 12 minutes. ONB was successful in 52 (94.54%) of the cases while failure in 3 (5.45%) resulted in conversion to general anesthesia for the completion of TURBT.
Conclusion: Blind obturator nerve block (ONB) by using Labat technique for obturator nerve block has proven to be simple, reliable and easily replicable in any set up and it does not require any time consuming steps or sophisticated equipment.