This study aims to determine the efficacy and safety of the Pericapsular Nerve Group (PENG) block in preventing obturator nerve reflex during transurethral resection of bladder tumors.
During transurethral resection of bladder tumors (TURBT), obturator nerve reflex is easily triggered during electrocautery. Currently, two primary methods are used to prevent obturator nerve reflex: deep neuromuscular blockade under general anesthesia and obturator nerve block. To date, no studies have confirmed the efficacy of the Pericapsular Nerve Group (PENG) block in preventing obturator nerve reflex. This study recorded the percentage decrease in adductor muscle strength at various time points after the PENG block, the occurrence of intraoperative adductor muscle spasms, the duration of nerve block procedure, and the incidence of postoperative adverse events. The completion of this study could provide clinical evidence for selecting anesthesia methods in TURBT procedures and offer robust evidence-based support for relevant medical decisions by government health agencies.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
68
A convex ultrasound probe (frequency 2-5 MHz) was positioned at the patient's inguinal ligament, with one end directed toward the anterior inferior iliac spine (AIIS), clearly visualizing the bony prominences of the iliopubic eminence and the AIIS. The needle tip was directed medially toward the pectineus muscle. Upon reaching the space between the pectineus muscle and the pubic bone, and after confirming the absence of blood on aspiration, 30 ml of 0.375% ropivacaine was injected.
An ultrasound probe was positioned at the inguinal ligament, with the needle inserted parallel to the long axis of the probe. After confirming no blood upon aspiration, 15 ml of 0.375% ropivacaine was injected into the fascial plane between the adductor brevis and adductor magnus, as well as into the midportion of the adductor longus and adductor brevis muscles.
Nanjing First Hospital
Nanjing, Jiangsu, China
the percentage reduction in adductor muscle strength at 5, 10, 15, 20, 25, 30 minutes, and 3 hours after drug administration, compared to pre-administration levels.
The percentage increase in adductor strength from preoperative to postoperative measurements divided by preoperative adductor strength is larger, reflecting a better nerve block effect and superior obturator nerve reflex inhibition.
Time frame: 5, 10, 15, 20, 25, 30 minutes, and 3 hours post-administration
Presence of obturator nerve reflex during surgery
Obturator nerve reflex grading system: No response in the adductor muscle group of the thigh; mild muscle twitching in the adductor muscle group of the thigh; severe contraction of the adductor muscle group of the thigh
Time frame: During surgery
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