Classic versus Inguinal Approach for Obturator Nerve Block in Transurethral Resection of Bladder Cancer under Spinal Anesthesia: A Randomized Controlled Trial
Single spinal anesthesia in transurethral resection of bladder tumor (TURBT) has been reported to be unable to prevent obturator nerve stimulation and adductor muscle contraction, which can cause complications like bladder perforation. The present study aimed to compare the effectiveness of the clas...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Shiraz University of Medical Sciences
2018-01-01
|
| Series: | Iranian Journal of Medical Sciences |
| Subjects: | |
| Online Access: | http://ijms.sums.ac.ir/index.php/IJMS/article/view/3603 |
| _version_ | 1818187478002040832 |
|---|---|
| author | Dawood Aghamohammadi Reza Movassaghi Gargari Solmaz Fakhari Eissa Bilehjani Sepideh Poorsadegh |
| author_facet | Dawood Aghamohammadi Reza Movassaghi Gargari Solmaz Fakhari Eissa Bilehjani Sepideh Poorsadegh |
| author_sort | Dawood Aghamohammadi |
| collection | DOAJ |
| description | Single spinal anesthesia in transurethral resection of bladder tumor (TURBT) has been reported to be unable to prevent obturator nerve stimulation and adductor muscle contraction, which can cause complications like bladder perforation. The present study aimed to compare the effectiveness of the classic and inguinal approaches for obturator nerve block (ONB). Seventy patients with cancers of the lateral wall of the bladder, scheduled to undergo TURBT at Imam Reza Hospital (Tabriz, Iran) during a 6-month period as of June 2016, were randomly allocated to groups of inguinal and classic methods (n=35). After the infusion of 500 mL of normal saline, spinal anesthesia was commenced using 3 mL (15 mg) of bupivacaine. Then ONB was performed using 10 mL of 1% lidocaine via the inguinal or classic approach in the inguinal group or the classic group, respectively. The success rate, defined as lack of post-block contraction with stimulation or during surgery, number of puncture attempts, time of block onset, and patient and surgeon satisfaction, was compared between the 2 methods using SPSS, version 19. The success rate of ONB was significantly higher in the inguinal group (97.1% vs. 71.4%; P=0.003). The number of puncture attempts in the classic group was more than that in the inguinal group (3.71±1.10 vs. 1.66±0.68, respectively; P<0.001). The block onset time was shorter in the inguinal group (1.5±0.66 min vs. 2.9±1.18 min; P<0.001). Dissatisfaction of the patient (19 cases vs. 2 cases) and the surgeon (10 cases vs. no case) was higher in the classic group (P<0.001).
Compared to the classic approach, the inguinal approach for ONB appeared to be an easily performable, effective block with a high success rate, rapid onset, and good patient and surgeon satisfaction.
Trial Registration Number: IRCT 201608171772N21 |
| first_indexed | 2024-12-11T23:11:40Z |
| format | Article |
| id | doaj.art-44df77f83d104433ab95b6b9a1ded962 |
| institution | Directory Open Access Journal |
| issn | 0253-0716 1735-3688 |
| language | English |
| last_indexed | 2024-12-11T23:11:40Z |
| publishDate | 2018-01-01 |
| publisher | Shiraz University of Medical Sciences |
| record_format | Article |
| series | Iranian Journal of Medical Sciences |
| spelling | doaj.art-44df77f83d104433ab95b6b9a1ded9622022-12-22T00:46:41ZengShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-07161735-36882018-01-014317580Classic versus Inguinal Approach for Obturator Nerve Block in Transurethral Resection of Bladder Cancer under Spinal Anesthesia: A Randomized Controlled TrialDawood Aghamohammadi0Reza Movassaghi Gargari1Solmaz Fakhari2Eissa Bilehjani3Sepideh Poorsadegh4Pain and Palliative Center, Tabriz University of Medical Sciences, Tabriz, IranPain and Palliative Center, Tabriz University of Medical Sciences, Tabriz, IranPain and Palliative Center, Tabriz University of Medical Sciences, Tabriz, IranDepartment of Anesthesiology, Madani Heart Hospital, Tabriz University of Medical Sciences, Tabriz, IranFaculty of Medicine, Tabriz University of Medical Sciences, Tabriz, IranSingle spinal anesthesia in transurethral resection of bladder tumor (TURBT) has been reported to be unable to prevent obturator nerve stimulation and adductor muscle contraction, which can cause complications like bladder perforation. The present study aimed to compare the effectiveness of the classic and inguinal approaches for obturator nerve block (ONB). Seventy patients with cancers of the lateral wall of the bladder, scheduled to undergo TURBT at Imam Reza Hospital (Tabriz, Iran) during a 6-month period as of June 2016, were randomly allocated to groups of inguinal and classic methods (n=35). After the infusion of 500 mL of normal saline, spinal anesthesia was commenced using 3 mL (15 mg) of bupivacaine. Then ONB was performed using 10 mL of 1% lidocaine via the inguinal or classic approach in the inguinal group or the classic group, respectively. The success rate, defined as lack of post-block contraction with stimulation or during surgery, number of puncture attempts, time of block onset, and patient and surgeon satisfaction, was compared between the 2 methods using SPSS, version 19. The success rate of ONB was significantly higher in the inguinal group (97.1% vs. 71.4%; P=0.003). The number of puncture attempts in the classic group was more than that in the inguinal group (3.71±1.10 vs. 1.66±0.68, respectively; P<0.001). The block onset time was shorter in the inguinal group (1.5±0.66 min vs. 2.9±1.18 min; P<0.001). Dissatisfaction of the patient (19 cases vs. 2 cases) and the surgeon (10 cases vs. no case) was higher in the classic group (P<0.001). Compared to the classic approach, the inguinal approach for ONB appeared to be an easily performable, effective block with a high success rate, rapid onset, and good patient and surgeon satisfaction. Trial Registration Number: IRCT 201608171772N21http://ijms.sums.ac.ir/index.php/IJMS/article/view/3603Obturator nerve blockUrinary bladder neoplasmsTransurethral resectionInguinal approachClassic approach |
| spellingShingle | Dawood Aghamohammadi Reza Movassaghi Gargari Solmaz Fakhari Eissa Bilehjani Sepideh Poorsadegh Classic versus Inguinal Approach for Obturator Nerve Block in Transurethral Resection of Bladder Cancer under Spinal Anesthesia: A Randomized Controlled Trial Iranian Journal of Medical Sciences Obturator nerve block Urinary bladder neoplasms Transurethral resection Inguinal approach Classic approach |
| title | Classic versus Inguinal Approach for Obturator Nerve Block in Transurethral Resection of Bladder Cancer under Spinal Anesthesia: A Randomized Controlled Trial |
| title_full | Classic versus Inguinal Approach for Obturator Nerve Block in Transurethral Resection of Bladder Cancer under Spinal Anesthesia: A Randomized Controlled Trial |
| title_fullStr | Classic versus Inguinal Approach for Obturator Nerve Block in Transurethral Resection of Bladder Cancer under Spinal Anesthesia: A Randomized Controlled Trial |
| title_full_unstemmed | Classic versus Inguinal Approach for Obturator Nerve Block in Transurethral Resection of Bladder Cancer under Spinal Anesthesia: A Randomized Controlled Trial |
| title_short | Classic versus Inguinal Approach for Obturator Nerve Block in Transurethral Resection of Bladder Cancer under Spinal Anesthesia: A Randomized Controlled Trial |
| title_sort | classic versus inguinal approach for obturator nerve block in transurethral resection of bladder cancer under spinal anesthesia a randomized controlled trial |
| topic | Obturator nerve block Urinary bladder neoplasms Transurethral resection Inguinal approach Classic approach |
| url | http://ijms.sums.ac.ir/index.php/IJMS/article/view/3603 |
| work_keys_str_mv | AT dawoodaghamohammadi classicversusinguinalapproachforobturatornerveblockintransurethralresectionofbladdercancerunderspinalanesthesiaarandomizedcontrolledtrial AT rezamovassaghigargari classicversusinguinalapproachforobturatornerveblockintransurethralresectionofbladdercancerunderspinalanesthesiaarandomizedcontrolledtrial AT solmazfakhari classicversusinguinalapproachforobturatornerveblockintransurethralresectionofbladdercancerunderspinalanesthesiaarandomizedcontrolledtrial AT eissabilehjani classicversusinguinalapproachforobturatornerveblockintransurethralresectionofbladdercancerunderspinalanesthesiaarandomizedcontrolledtrial AT sepidehpoorsadegh classicversusinguinalapproachforobturatornerveblockintransurethralresectionofbladdercancerunderspinalanesthesiaarandomizedcontrolledtrial |