Purpose: Transurethral resection of bladder tumour (TURBT) is done under general anaesthesia (GA) with muscle relaxation to prevent obturator jerk and bladder perforation. TURBT under spinal anaesthesia (SA) with obturator nerve block (ONB) may prevent the obturator jerk while eliminating the disadvantages of GA. Objectives: To assess the outcome of TURBT under SA and ONB. Methods: Patients undergoing TURBT for lateral wall tumours from 01.11.2017 to 30.10.2020 were prospectively studied. Anterior branch of obturator nerve with plain Bupivacaine was blocked with the guidance of an ultrasound scan and a nerve stimulator. Significant obturator jerk which necessitated conversion to GA was defined as failed ONB. Results: Out of 72 patients with mean age of 66.7 years underwent ONB, 61 (84.7%) were men. Fifty two (72.2%) had unilateral and 20 (27.8%) had bilateral blocks. Sixty one (84.7%) patients had no obturator jerk whereas 5 (7%) had a mild jerk which did not preclude safe resection. Six patients (8.3%) had a failed ONB requiring conversion to GA. None had a bladder perforation requiring laparotomy, developed neurovascular injury or anaesthetic toxicity and only one patient required intensive care monitoring. Conclusion: SA with anterior branch of ONB is an effective and safe alternative to GA with muscle relaxation for TURBT although a randomized trial is necessary to determine the true efficacy and safety over the other.
Results: The number of patients diagnosed with acute renal failure in 7 months was 51 patients. The sex ratio was 2.5 and the mean age was 39.92 AE 26.50 years, with a gap between 4 months and 91 years. Mean serum creatinine was 32.86 AE 24.4 mg / l and hemoglobin 7.45 g / l AE 3.15 g / l. There were 7 patients (13.72%) who underwent hemodialysis and the indications were acute pulmonary oedema and disorders of consciousness. Infections were the main causes of AKI (24 cases or 47.05%). Other causes of AKI were cardio-renal syndrome (8 cases or 15.68%), anemia (7 cases or 13.75%), hepatorenal syndrome (6 cases or 11.76%), AKI postoperative (4 cases). 7.84%) andtaking NSAIDs (2 cases or 3.92%). We report 5 deaths among these AKI. Conclusions: The AKI affects all ages and causes are diverse, but infections are a priority. Serum creatinine was not an indication for hemodialysis. seven patients were hemodialyzed, we would to have a work on AKI in infections in Congo Brazzaville.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.