Background: The most signicant use of ONB i.e., obturator nerve block is to prevent adductor muscle
contraction associated with Transurethral resection of bladder tumours (TURBT). Adductor jerk during
TURBT may cause serious injury to urinary bladder like laceration with involvement of blood vessels, severe bleeding, bladder
wall tear and perforation and even partial resection of bladder tumour due to frequent distraction and interruption to the
surgeon.1 So, there is need for evaluation and comparison of different techniques of ONB in view of safety and efcacy. We
have conducted a randomized clinical study to compare the classic pubic and inter adductor approach for ONB with spinal
anaesthesia for transurethral resection of bladder wall tumour masses.
Method: A total number of 50 patients of either sex of ASA physical status I or II, of age group 30-75 years, who were posted for
TURBT operation under spinal anaesthesia, were included in this study. A Prospective single blind randomised controlled trial
and cross over study was conducted. Peripheral nerve stimulator to localize the nerve and Inj. Ropivacaine 0.5% ,15 ml on each
side was used in this study.
Result: The overall success rate in classic pubic approach was slightly lower than interadductor approach which was
statistically insignicant. There were more instances of vessel puncture in pubic approach, which was statistically signicant
(p value = 0.016). There was no incidence of other signicant complications.
Conclusion: In terms of ease of obturator nerve block and incidence of complications the interadductor approach is better than
classic pubic approach.
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