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Original Article

PAFMJ. 2017; 67(2): 199-202


AN EFFECTIVE TECHNIQUE OF OBTURATOR NERVE BLOCK TO PREVENT ADDUCTOR REFLEX DURING TRANSURETHRAL RESECTION OF BLADDER TUMOR

Haroon Sabir Khan, Abdullah Arshad, Sohail Sabir, Arshad Mehmood.

Abstract
Objective: To observe the efficacy of blind obturator nerve block by Labat technique for prevention of obturator
jerk during transurethral resection of bladder tumor performed under spinal anesthesia.
Study Design: Descriptive Study.
Material and Methods: This was a single center based study conducted at tertiary care military hospital for a
period of thirty months. Fifty five patients were recruited in the study, after identifying the location of bladder
growth in the lateral wall on ultrasound USG and confirming its exact site on cystoscopic examination. Those
eliciting obturator jerk during transurethral resection of bladder tumor (TURBT) were included and ONB was
performed using 2% lidocaine via blind technique of Labat. TURBT was restarted and presence of obturator jerk
was recorded if evoked (primary outcome).
Results: Median age was 67.3 8 years with majority (72.7%) in the age group between 61 to 80 years. Male
female ratio was 7:1. Fifty (90%) patients presented with solitary growth. Mean operating time was 28.8 12
minutes. ONB was successful in 52 (94.54%) of the cases while failure in 3 (5.45%) resulted in conversion to
general anesthesia for the completion of TURBT.
Conclusion: Blind obturator nerve block (ONB) by using Labat technique for obturator nerve block has proven to
be simple, reliable and easily replicable in any set up and it does not require any time consuming steps or
sophisticated equipment.

Key words: Adductor reflex, Labat approach, Obturator nerve block, TURBT, Transurethral resection of bladder tumors, Urinary bladder growths.



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