Comparison of Ultrasound-Guided Nerve Block with Ultrasound-Guided Nerve Stimulation Technique for Obturator Nerve Block in Transurethral Resection of Bladder Tumour

Mirza Sijeel Ahmad; Umer Khan; Syed Aftab Haider; Atqua Sultan; Shazia Khanum; Muhammad Saleem Saleemi

doi:10.51253/pafmj.v73i3.5435

Authors

Mirza Sijeel Ahmad Department of Anesthesia, Combined Military Hospital, Multan/National University of Medical Sciences (NUMS) Pakistan
Umer Khan Department of Anesthesia, Combined Military Hospital, Lahore/National University of Medical Sciences (NUMS) Pakistan
Syed Aftab Haider Department of Anesthesia, Nishtar Medical University, Multan Pakistan
Atqua Sultan Department of Anesthesia, Multan Institute of Kidney Diseases, Multan Pakistan
Shazia Khanum Department of Anesthesia, Multan Institute of Kidney Diseases, Multan Pakistan
Muhammad Saleem Saleemi Department of Anesthesia, Multan Institute of Kidney Diseases, Multan Pakistan

DOI:

https://doi.org/10.51253/pafmj.v73i3.5435

Keywords:

Nerve stimulation, Obturator nerve block, Ultrasound

Abstract

Objective: To compare the ultrasound-guided nerve block with ultrasound-guided nerve stimulation technique for obturator nerve block (ONB) in patients undergoing transurethral resection of bladder tumour (TURBT).

Study Design: Prospective comparative study.

Place and Duration of Study: Department of Anesthesiology, Nishtar Medical University/Hospital Multan from Jan to Jul 2019.

Methodology: A total of 80 patients were divided into two groups. In Group-I, an ultrasound-guided nerve block was applied, while in Group-II, an ultrasound-guided nerve stimulation technique was applied for the block. Time of onset/ success of motor block and ease of approach were the primary study endpoints. At the same time, the surgeon and patient satisfaction were secondary endpoints.

Results: Motor block onset time was 6.58±2.16 minutes in Group-II versus 12.41±2.39 minutes in Group-I (p-value <0.001). Block performance time was 4.34±0.78 minutes in Group-II versus 2.09±0.46 minutes in Group-I (p-value <0.001). The block success rate was also higher in Group-II, with 36(90%) patients, compared to 31(77.5%) in Group-I, with an insignificant pvalue of 0.12. Surgeons were satisfied by the quality of the obturator nerve block in 37(92.5%) cases in Group -II and only 30 (75%) cases in Group-I (p-value 0.03).

Conclusion: The ultrasound-guided nerve stimulator is superior to the Ultrasound-guided nerve block for Obturator nerve block (ONB) and is associated with higher patient and surgeon satisfaction.