Obturator nerve block; transurethral resection of lateral bladder wall tumours [TUR-BT]

ABSTRACT

To evaluate the efficacy of obturator nerve block combined with spinal anaesthesia for prevention of adductor muscle spasm and its associated complications during transurethral resection of bladder tumours located at its lateral and inferolateral wall. A prospective study. At AFIU Rawalpindi. From January 2005 to December 2006. Material and method Fifty patients who had tumours at their lateral / inferolateral bladder wall of physical status ASA I - IV received spinal anaesthesia at 3rd or 4th lumbar space followed by obturator nerve block with a view to preventing adductor jerk during resection of tumour. There was complete suppression of adductor jerk in 45 [90%] patients and surgery was completed smoothly. Two patients [4%] had mild adductor jerk and additional sedation was required. The block failed to work in 3 [6%] cases and required conversion to general anaesthesia. Thus the procedure was successful in 94% [complete and partial suppression of jerk. We conclude that spinal anaesthesia combined with obturator nerve block is an effective technique for preventing adductor jerk during TUR-BT, thus avoiding intra-operative and post operative complication