Objectives: To assess the efficacy and safety of spinal anesthesia combined with obturator nerve block (ONB) for transurethral resection of bladder tumor. Subjects and methods: A prospective study was carried out on 10 patients who underwent spinal anesthesia combined with ONB using nerve stimulation for transurethral resection of bladder tumor. | JOURNAL OF MILITARY PHARMACO-MEDICINE N07-2016 INITIAL ASSESSMENT OF EFFICACY AND SAFETY OF SPINAL ANESTHESIA COMBINED WITH OBTURATOR NERVE BLOCK FOR TRANSURETHRAL RESECTION OF BLADDER TUMOR Nguyen Trung Kien*; Hoang Van Chuong*; Tran Van Hinh* Nguyen Phu Viet*; Pham Quang Vinh* SUMMARY Objectives: To assess the efficacy and safety of spinal anesthesia combined with obturator nerve block (ONB) for transurethral resection of bladder tumor. Subjects and methods: A prospective study was carried out on 10 patients who underwent spinal anesthesia combined with ONB using nerve stimulation for transurethral resection of bladder tumor. Quality of anesthesia, violent adductor contraction and inadvertent bladder perforation as well as side effects were monitored. Results: All patients had an excellent quality of anesthesia, distance from skin to obturator nerve was ± cm on everage, 9 patients were absent of leg jerking. Side effects included shiving in 2 cases, hypotension in 1 case and bradycardia in 1 case. Conclusion: Combination of spinal anesthesia and ONB provided good effective anesthesia for transurethral resection of bladder tumor: adductors muscle spasms were absent in 90%, side effects were transient and mild. * Key words: Bladder tumor; Spinal anesthesia; Obturator nerve block; Transurethral resection of bladder tumor. INTRODUCTION Bladder cancer is the fourth most common cancer in men in the world. The obturator nerve may be accidentally stimulated during transurethral resection of lateral bladder wall tumors, causing adductor contraction. Spinal anesthesia is a favoured anaesthetic technique but the rate of adductor spasm can get as high as 40% [3]. That is also the main reason leading to bladder wall perforation and increase morbidity. Methods of preventing the stimulation of the obturator nerve include: reduction of the electrocautery power, bipolar resection, general anesthesia, or ONB following spinal anesthesia [8]. The objective of this study .
