Why the study?
Anesthesia for urological surgeries presents unique problems due to patient factors and procedure complexity, highlighting the need to explore regional anesthesia techniques like epidural anesthesia and obturator nerve block in high-risk patients.
Epidural anesthesia combined with an obturator nerve block represents a feasible anesthetic strategy for high-risk patients with severe cardiac and respiratory comorbidities undergoing TURBT.
May support regional anesthesia for high-risk TURBT; leaves open need for prospective validation before wider adoption.
Epidural Anesthesia (EA) is mainly used for perioperative and postoperative analgesia, usually combined with Spinal Anesthesia (SA) or General Anesthesia (GA). It is safe, easy to perform, and has multiple applications. The benefits of Regional Anesthesia (RA) over general anesthesia include superior analgesia, reduced opioid consumption, reduced pulmonary complications, improved gastrointestinal function, early mobilization, a reduced need for thrombo-prophylaxis, early discharge, and higher patient satisfaction. Anesthesia for urological surgeries has unique problems due to patient factors and procedure complexity. An 84-year older man with a known history of hypertension/ Coronary Artery Disease (CAD)/ complete Left Bundle Branch Block (LBBB)/ dilated cardiomyopathy/ glottic carcinoma/ mixed airway disease, with an ejection fraction of 30%, was scheduled to undergo Transurethral Resection of Bladder Tissue (TURBT) for carcinoma bladder mass. It was done under EA and an ipsilateral obturator nerve block.
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Kabi et al. (2021) studied this question.
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