Obturator nerve block under double control with ultrasound and neurostimulation during transurethral resection of lateral bladder wall tumors

Abstract

50 patients were enrolled in the prospective randomized trials; they all underwent transurethral resection of lateral bladder wall tumors. In general anesthesia group (GA) (n = 25), muscle relaxants were used for general anesthesia; in the group of ultrasound + neurostimulation (US + NS) (n = 25), spinal anesthesia was performed through obturator nerve block with a 2% lidocaine solution of 10 ml under double control: ultrasound navigation and neurostimulation. Results . An adductor spasm was observed in 5 (20%) patients of the GA group; in the US+ NS group, it was absent (p = 0.025). The frequency of arterial hypotension in the US + NS group was lower compared to the GA group 0 vs 32% (p = 0.004), as well as the frequency of sinus bradycardia: 16% versus 48% (p = 0.032). The patient’s stay in the operating room in the US + NS group was 42 (38; 50) minutes versus 60 (50; 85) minutes in the GA group (p = 0.002). Spinal anesthesia with the obturator nerve block under double control guaranteed the absence of adductor spasm during resection of lateral bladder wall tumors along with lower frequency of arterial hypotension, sinus bradycardia, as well as a reduction of the time spent in the operating room.