Abstract:
PURPOSE:To evaluate the efficacy of transvesical obturator nerve block (ONB) in the prevention of obturator nerve reflex and leg jerking during transurethral resection of bladder tumors (TURBT). PATIENTS AND METHODS:A total of 60 patients were studied, in whom the transurethral resection of tumors on the posterolateral bladder wall were performed under spinal anesthesia (SA). The patients were randomly divided into two groups. In the first group, we performed transvesical ONB and SA together, while the second group received only SA. The patients underwent TURBT using monopolar cautery. Incidence of leg jerking was registered and compared in these two groups. We used a nerve stimulator to detect the obturator nerve next to the lateral bladder wall. The obturator nerve was identified by its response to nerve stimulation. Then, 10 mL of 1% lidocaine was slowly injected through the working channel of a cystoscope. RESULTS:In the intervention group, 34 ONBs (4 bilateral and 26 unilateral) were tried. We could not detect the obturator nerve by nerve stimulation in six patients, and lidocaine injection was carried out blindly in these cases. One patient in the intervention group experienced adductor contraction. Among 30 patients in the control group, 5 patients had leg jerking, and in 2 patients, the procedure ended incompletely because of muscle spasm. Comparing these two groups, transvesical ONB effectively decreased leg jerking during TURBT (16.5% vs 3%; P < 0.05). CONCLUSION:Local blockade of the obturator nerve during cystoscopy is an effective method to avoid its stimulation in TURBT. It can be performed easily, and we did not experience any serious complication.
journal_name
J Endouroljournal_title
Journal of endourologyauthors
Khorrami MH,Javid A,Saryazdi H,Javid Mdoi
10.1089/end.2009.0659subject
Has Abstractpub_date
2010-10-01 00:00:00pages
1651-4issue
10eissn
0892-7790issn
1557-900Xjournal_volume
24pub_type
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journal_title:Journal of endourology
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journal_title:Journal of endourology
pub_type: 杂志文章
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journal_title:Journal of endourology
pub_type: 杂志文章,随机对照试验
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pub_type: 杂志文章,meta分析,评审
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journal_title:Journal of endourology
pub_type: 杂志文章,评审
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journal_title:Journal of endourology
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abstract::We herein present the first case in the literature of enucleation of an aldosterone-producing adenoma by laparoscopy. The indication for adrenal-sparing surgery was bilateral adrenal adenoma. The operation turned out to be easier than laparoscopic adrenalectomy. The postoperative course was uneventful, and the patient...
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pub_type: 杂志文章
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pub_type: 杂志文章
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pub_type: 杂志文章
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