A Different Obturator Nerve Block Approach Using Nerve Stimulation Device Under Fluoroscopy Guidance in the Transurethral Resection of Lateral Bladder Wall Tumors
Journal Title: The Medical Bulletin of Haseki - Year 2021, Vol 59, Issue 2
Abstract
Aim: This study aims to define the efficacy and safety of a different obturator nerve block technique using fluoroscopy and nerve stimulation device during transurethral resection of bladder tumor (TUR-BT). Methods: Sixty patients with lateral bladder wall tumors who had TURBT were retrospectively analyzed for the formation of obturator reflex. Thirty patients received spinal anesthesia (SA) and 30 patients received SA combined with an obturator nerve block (ONB). ONB was performed in the lithotomy position. A percutaneous needle was advanced to the superolateral portion of the obturator foramen under fluoroscopic guidance. The nerve was localized with a nerve stimulation device and 5 mL of 2% prilocaine was injected to perineural area. Additionally, the tumor base was marked intravesically by resectoscope with fluoroscopy and 5 mL of %2 prilocaine was administered to nearby tissue. Obturator reflex formation reflex-related related complications were compared between the two groups. Results: The results of our study yielded a statistically significant difference in the favor of ONB compared to SA alone for the occurrence of obturator reflex (13% vs 43%, p=0.020), bladder perforation (0% vs 23.3%, p=0.002), and absence muscle tissue in the pathological specimen (10% vs 40%, p=0.01). Conclusion: ONB with the help of a nerve stimulation device, directed by fluoroscopy is effective to prevent obturator reflex and related complications.
Authors and Affiliations
Cuneyd Sevinc, Tahir Karadeniz
Keywords
Related Articles
- EP ID EP693396
- DOI 10.4274/haseki.galenos.2021.6813
- Views 94
- Downloads 0
Removal of Two Needles from the Liver and Axillary Region Using Ultrasound: A Case Report with Current Literature Review
Foreign body (FB) ingestion is a serious problem in children. A small number of the FBs swallowed migrate from the gastrointestinal tract to the peritoneal cavity or solid organs in the abdomen such as the liver. Imaging...
Papilledema: Could It Be an Important Clinical Sign of Leptomeningeal Metastasis?
Aim: Leptomeningeal metastasis (LM), which can be seen in all types of cancer, is a rare condition with poor prognosis. Diagnosis and treatment are important components of the management of the disease. We aimed to revea...
Attitudes of Pharmacy Workers on Rational Drug Therapy: A Cross Sectional Survey
Aim: To assess the pharmacy workers’ role in rational drug therapy and to draw attention to the missing points. Methods: The questionnaire used in this study was mainly based on the questions included in the “Hospital P...
Rare Cause of Genital Bleeding: Urethral Prolapse
Urethral prolapse (UP) is a condition characterized by circumferential prolapse of the urethral mucosa through the external meatus generally seen in girls. Bleeding, dysuria and an asymptomatic prolapsed mass are the mai...
Use of Snake Camera (Boroscope) During Percutaneous Tracheostomy
Tracheostomy is one of the oldest surgical procedures. The percutaneous dilatational tracheostomy (PDT) technique, first used by Shelden has been modified by Ciaglia. They reported that the technique facilitates the proc...