Journal of anaesthesiology, clinical pharmacology · 2025
Comparison of proximal versus distal approach for ultrasound-guided obturator nerve block for prevention of adductor spasm in patients undergoing transurethral resection of urinary bladder tumors.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Kumar Vinod, Meena Dharam S, Gupta Arushi, Muwal Simmi
Аннотация
BACKGROUND AND AIMS: Adductor muscle spasm occurs when the obturator nerve is directly stimulated by the electrical current transmitted by the resectoscope. Ultrasound-guided ONB is regarded as the optimal technique and is classified as the proximal and distal approach based on the anatomical location of the obturator nerve.
MATERIAL AND METHODS: This study included 90 adult patients of ASA grades I-III and aged more than 18 years undergoing transurethral resection of bladder tumors under spinal anesthesia. Patients were randomized into two groups: group P received ultrasound-guided obturator nerve block (ONB) by proximal approach, and group D received ultrasound-guided ONB by distal approach. Adductor muscle power after the block, block performance time, complications, and adductor jerks during surgery were compared. A P value of < 0.05 was considered statistically significant.
RESULTS: Adductor jerks during the surgery were absent in 85.7% of patients in group P and 78.0% of patients in group D. The mean block performance time in group P was 4.33 ± 0.38 minutes, and in group D was 4.00 ± 0.34 minutes. Vascular puncture during the block was observed in nine patients in group P and two patients in group D.
CONCLUSION: The success rate in terms of the absence of adductor spasm during surgery was higher in proximal than in distal ultrasound-guided ONB. However, the proximal technique requires more time to perform the block than the distal technique, as it is technically challenging and carries a risk of vascular puncture.
MATERIAL AND METHODS: This study included 90 adult patients of ASA grades I-III and aged more than 18 years undergoing transurethral resection of bladder tumors under spinal anesthesia. Patients were randomized into two groups: group P received ultrasound-guided obturator nerve block (ONB) by proximal approach, and group D received ultrasound-guided ONB by distal approach. Adductor muscle power after the block, block performance time, complications, and adductor jerks during surgery were compared. A P value of < 0.05 was considered statistically significant.
RESULTS: Adductor jerks during the surgery were absent in 85.7% of patients in group P and 78.0% of patients in group D. The mean block performance time in group P was 4.33 ± 0.38 minutes, and in group D was 4.00 ± 0.34 minutes. Vascular puncture during the block was observed in nine patients in group P and two patients in group D.
CONCLUSION: The success rate in terms of the absence of adductor spasm during surgery was higher in proximal than in distal ultrasound-guided ONB. However, the proximal technique requires more time to perform the block than the distal technique, as it is technically challenging and carries a risk of vascular puncture.