Physiologic Advantages of Peripheral Nerve Blockade Translate to Decreased Length of Stay and Improved Patient Satisfaction

Kerfeld, Mitchell J.; Hambsch, Zakary J.; McEntire, Dan; Kirkpatrick, Daniel R.; Cai, Jun; Youngblood, Charles F.; Agrawal, Devendra K.; Reisbig, Mark D.

doi:10.17140/rpaoj-1-103

Cited by 5 publications

(5 citation statements)

References 38 publications

(48 reference statements)

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“…A similar study by reported a success rate of 76.7% using US-guided ONB and 90% of patients using USguided nerve stimulation. 12 Another study by reported similar results; in their study, the success rate of ONB was 88% using US-guided nerve stimulation and 70% in US-guided nerve block only. 13 Finally, another study reported a success rate of 100% in the US-guided nerve stimulation group and only 80.6% in the US-guided nerve block-only group.…”

Section: Discussionmentioning

confidence: 67%

Comparison of Ultrasound-Guided Nerve Block with Ultrasound-Guided Nerve Stimulation Technique for Obturator Nerve Block in Transurethral Resection of Bladder Tumour

Ahmad,

Khan,

Haider

et al. 2023

PAFMJ

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Objective: To compare the ultrasound-guided nerve block with ultrasound-guided nerve stimulation technique for obturator nerve block (ONB) in patients undergoing transurethral resection of bladder tumour (TURBT). Study Design: Prospective comparative study. Place and Duration of Study: Department of Anesthesiology, Nishtar Medical University/Hospital Multan from Jan to Jul 2019. Methodology: A total of 80 patients were divided into two groups. In Group-I, an ultrasound-guided nerve block was applied, while in Group-II, an ultrasound-guided nerve stimulation technique was applied for the block. Time of onset/ success of motor block and ease of approach were the primary study endpoints. At the same time, the surgeon and patient satisfaction were secondary endpoints. Results: Motor block onset time was 6.58±2.16 minutes in Group-II versus 12.41±2.39 minutes in Group-I (p-value <0.001). Block performance time was 4.34±0.78 minutes in Group-II versus 2.09±0.46 minutes in Group-I (p-value <0.001). The block success rate was also higher in Group-II, with 36(90%) patients, compared to 31(77.5%) in Group-I, with an insignificant pvalue of 0.12. Surgeons were satisfied by the quality of the obturator nerve block in 37(92.5%) cases in Group -II and only 30 (75%) cases in Group-I (p-value 0.03). Conclusion: The ultrasound-guided nerve stimulator is superior to the Ultrasound-guided nerve block for Obturator nerve block (ONB) and is associated with higher patient and surgeon satisfaction.

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Section: Discussionmentioning

confidence: 67%

Comparison of Ultrasound-Guided Nerve Block with Ultrasound-Guided Nerve Stimulation Technique for Obturator Nerve Block in Transurethral Resection of Bladder Tumour

Ahmad,

Khan,

Haider

et al. 2023

PAFMJ

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“…11 Among these, peripheral nerve blocks are cost effective anaesthesia techniques which are used to achieve proper anesthesia by avoiding airway instrumentation and hemodynamic consequences of general and spinal anesthesia. 9,11,17 As we have mentioned earlier that several findings suggested ONB as to effective facilitating complete resection of a urinary bladder tumour by immobilizing the surgical field, avoiding nerve stimulation and jerks as well as preventing other complications like bleeding or bladder perforation, while doing TURBT. [8][9][10] Hence, for decades, ONB has become essential for performing TURBT safely and effectively.…”

Section: Discussionmentioning

confidence: 99%

“…9,11,17 As we have mentioned earlier that several findings suggested ONB as to effective facilitating complete resection of a urinary bladder tumour by immobilizing the surgical field, avoiding nerve stimulation and jerks as well as preventing other complications like bleeding or bladder perforation, while doing TURBT. [8][9][10] Hence, for decades, ONB has become essential for performing TURBT safely and effectively.…”

Section: Discussionmentioning

confidence: 99%

“…[4][5][6][7] Several studies reported that selective obturator nerve block (ONB) limits obturator reflex, adductor contraction, and leg jerking during TURBT operation, which ultimately prevents the abovementioned complications during surgery. [8][9][10] Labat, in 1922, first described an ONB technique based on surface landmarks. 11 However, in course of time, several advanced techniques have been introduced.…”

Section: Introductionmentioning

confidence: 99%

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Outcomes of Ultrasound Guided Versus Cystoscopy Guided Obturator Nerve Block (Obn) In Transurethral Resection Of Bladder Tumour (Turbt)

Zunaid¹,

Zunaid²,

Deb³

et al. 2023

J Dhaka Med Coll

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Context: Selective obturator nerve block (ONB) limits obturator reflex, adductor contraction, and leg jerking in transurethral resection of bladder tumour (TURBT), which ultimately prevents complications such as bleeding, bladder perforation, or incomplete tumor resection. The present study aims to compare the effectiveness of two different techniques of obturator nerve block during TURBT. Methods: A prospective, observational study was conducted in the Department of Anaesthesia, Analgesia, Palliative and Intensive Care Medicine, Dhaka Medical College Hospital, Dhaka, Bangladesh, between September 2018 and August 2019 to evaluate the effectiveness of ultrasound guided ONB versus cystoscopy guided ONB in TURBT operation. A total of 60 selected patients were randomly allocated into two groups: ultrasound guided ONB (group A) and cystoscopy guided ONB (group B) i.e. 30 in each group. Then onset of anesthesia (nerve block), tumour removal and patient outcome were assessed at different point during and after surgery. Results: Mean age of the patients was 54.7±8.53 years. In total, 34(57%) cases were male and 26(43%) were female. Male to female ratio was 1.3:1. In group A, 19(63.3%) patients had ASA II status and 11(36.7%) had ASA III status, while in group B, the numbers were 18(60%) and 12(40%) respectively. There was no significant difference in demographics and ASA status between two groups (P>0.05). Average onset of obturator nerve block was faster in group A (8.17±1.4 min) than group B (11.3±2.68 min), (P<0.001). Total resectability of tumours were achieved in 28(93.3%) in group A and 23(76.6%) in group B during operation (P<0.001), while 2(22.22%) and 7(77.77%) tumours had incomplete removal respectively (P<0.05). Among complications, adductor jerks were evident in 2(6.7%) and 7(23.3%), bladder perforation in 1(3.3%) and 4(13.3%), and bleeding in 1(3.3%) and 3(10.0%) cases in group A and group B respectively. The differences were statistically significant ((P<0.05). Conclusion: Although both techniques are safe and easy to perform, ultrasound guided ONB results in faster onset of block and better resectability of tumour with less complication over cystoscopy guided ONB. J Dhaka Med Coll. 2021; 30(2) : 208-213

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“…Teknik ini merupakan alternatif penggunaan opioid dosis tinggi dalam menurunkan angka kejadian hipertensi, takikardia, serta stres neuroendokrin. [6][7] Sekresi hormon adrenokortikotropik (ACTH) akibat stimulasi respons stres operasi bermanifestasi terhadap peningkatan sekresi katekolamin dan kortisol oleh glandula adrenal. Stimulasi kedua hormon tersebut mengganggu kerja insulin dan meningkatkan glikogenolisis sehingga terjadi peningkatan kadar glukosa darah.…”

Section: Pendahuluanunclassified

Perbandingan Antara Fentanil 2 μg/kgBB/jam dan Scalp Block Terhadap Peningkatan Hemodinamik dan Kadar Glukosa Darah Sewaktu Saat Pemasangan Pin Kepala Pada Kraniotomi

Sihombing

Bisri

Sitanggang

2018

JNI

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Latar Belakang dan Tujuan: Opioid dosis tinggi efektif memblokade nyeri pada operasi kraniotomi namun memiliki efek yang tidak diinginkan. Alternatif lain menggunakan teknik scalp block dikombinasikan dengan anestesi umum. Tujuan penelitian ini untuk membandingkan hemodinamik dan kadar glukosa darah sewaktu (GDS) antara fentanil 2 μg/kgBB/jam dan scalp block saat pemasangan pin kepala pada kraniotomi pengangkatan tumor elektif dengan anestesi umum. Subjek dan Metode: Penelitian ini dilakukan pada 28 pasien yang direncanakan pembedahan tumor otak elektif. Subjek penelitian dibagi menjadi dua kelompok: scalp block dan kelompok fentanil 2 μg/kgBB/jam. Tekanan arteri rerata, laju nadi dan kadar GDS intraoperatif dinilai dan dianalisis menggunakan uji-t berpasangan dan Chi-square. Hasil: MAP dan laju nadi antara kedua grup memiliki perbedaan signifikan (p<0,05). Kelompok fentanil memiliki MAP dan laju nadi lebih tinggi dibanding dengan kelompok scalp block. Namun perbandingan kadar GDS antara kedua kelompok tidak menunjukkan hasil yang signifikan (p>0,05). Simpulan: Scalp block lebih efektif dalam mengurangi peningkatan hemodinamik namun sama efektif dengan fentanil 2 μg/kgBB/jam dalam mengurangi peningkatan kadar GDS pada pasien yang menjalani operasi kraniotomi pengangkatan tumor elektif.

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Physiologic Advantages of Peripheral Nerve Blockade Translate to Decreased Length of Stay and Improved Patient Satisfaction

Cited by 5 publications

References 38 publications

Comparison of Ultrasound-Guided Nerve Block with Ultrasound-Guided Nerve Stimulation Technique for Obturator Nerve Block in Transurethral Resection of Bladder Tumour

Comparison of Ultrasound-Guided Nerve Block with Ultrasound-Guided Nerve Stimulation Technique for Obturator Nerve Block in Transurethral Resection of Bladder Tumour

Outcomes of Ultrasound Guided Versus Cystoscopy Guided Obturator Nerve Block (Obn) In Transurethral Resection Of Bladder Tumour (Turbt)

Perbandingan Antara Fentanil 2 μg/kgBB/jam dan Scalp Block Terhadap Peningkatan Hemodinamik dan Kadar Glukosa Darah Sewaktu Saat Pemasangan Pin Kepala Pada Kraniotomi

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