A prospective study of associated surgical hazards in trans-urethral resection of bladder tumor (turbt) comparing blind versus nerve stimulator guided obturator nerve block with spinal block

Introduction: Bladder cancer is the ninth most commonly diagnosed cancer worldwide. The overall incidence has increased by 10% since last 30 years and 5 years survival rate by 50% in European countries.1 Transurethral resection of bladder tumor (TURBT) is the standard treatment given to the patients of superficial bladder tumors. During TURBT, local anatomical anesthesia may be given in order to block the obturator nerve thus avoiding the obturator jerk reflex. This study analyzes the surgical hazards in TURBT comparing blind versus nerve stimulator guided obturator nerve block with spinal block. Materials and Methods: A prospective randomized study was done in which 30 patients at HIMS and associated hospitals, were divided into three groups to compare the surgical hazards in TURBT comparing blind versus nerve stimulator guided obturator nerve block with spinal block. Results: 30 patients were included in this study. Mean operative time in Group 1(Obturator nerve block (ONB) during TURBT via blind technique) was 38 minutes, in Group 2 (ONB during TURBT via nerve stimulation technique) was 35 minutes and in group 3 (TURBT under spinal anesthesia only was 64 minutes. Effectiveness of blind technique of obturator nerve block (Group 1) in our study was 80% while that via nerve stimulator guided technique (Group 2) was 90%. Conclusion: This study indicates that use Obturator nerve block during TURBT via nerve stimulation technique is a better technique as compared to ONB during TURBT via blind technique. The use of nerve stimulator before ONB has better outcome.