Clinical application of the obturator nerve block beside vessel in transurethral resection of bladder tumor / 中国内镜杂志

ABSTRACT

Objective To compare the operational feasibility and efficacy of inguinal obturator nerve block (ONB) beside the vessel by ultrasound combined with nerve stimulation and traditional ONB guided by nerve stimulation preventing obturator nerve reflex. Methods Forty patients with American Society of Anesthesiology (ASA)Ⅰ or Ⅱ, aged 35~91 years who underwent transurethral electric excision of bladder tumor in our hospital in 2014 were ran-domly divided into beside vessel group (group V, = 20) and traditional group (group T, = 20). Adductor strength was measured before and after the block. Frequencies of obturator nerve block puncture, operation time, visual ana-log scale (VAS) pain score, and incidence of complications were recorded during and after ONB. Results The suc-cess rate of the first puncture was significantly higher in group V than that in group T ( <0.01). The operation time in group V was significantly shorter than that in group T ( < 0.01). The decreased degree of adductor strength has significant difference of the two groups ( < 0.05 or < 0.01). The VAS pain score in group T was higher than that in groups V ( < 0.01). There are two cases contract blood vessel in group T, while none in group V ( < 0.01). There was no case with the local anesthetic toxicity and paresthesia in the area of the obturator nerve and the obtu-rator nerve injury in the two groups. Conclusion Compared with traditional ONB guided by nerve stimulation, in-guinal ONB beside the vessel by ultrasound combined with nerve stimulation showed more accurate positioning, less adjustment, less puncture time, more comfortable and safe.