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Abstract：
Background This study aimed to compare ultrasound versus ultrasound with nerve stimulation-guided obturator nerve block (ONB) for the prevention of adductor spasm in patients undergoing transurethral resection of bladder tumor (TURBT). Methodology This randomized controlled study included 240 adult patients in the age group of 30 to 70 years undergoing TURBT for lateral and posterolateral wall bladder tumors who fulfilled the American Society of Anesthesiologists grade I and II criteria. The patients were divided into two groups: group U (n = 120) included patients who underwent ONB using an ultrasound-guided technique and group UN (n = 120) included patients who underwent ONB using ultrasound with the nerve stimulation technique. Block performance time, adductor jerks/spasms, adductor muscle power, and patient and surgeon satisfaction were compared. A P-value <0.05 was considered statistically significant. Results The mean block performance time in group U was significantly less (4.4 ± 0.82 minutes) than in group UN (6.55 ± 0.37 minutes). Compared to group U, group UN had significantly fewer adductor jerks/spasms during the surgery (7.76% vs. 20.35%, p = 0.006), significantly more surgeon satisfaction (92.24% vs. 79.65%, p = 0.006), significantly more patient satisfaction (92.24% vs. 79.65%, p = 0.006), and comparable complications (excessive bleeding and minor bladder injury) and adductor muscle power after the block (p > 0.05). Conclusions ONB using the nerve stimulation technique under ultrasound guidance has a longer mean block performance time, a higher success rate, and higher surgeon satisfaction than ONB under ultrasound guidance only.
摘要：
背景这项研究旨在比较超声与超声与神经刺激引导的闭孔神经阻滞（ONB）预防经尿道膀胱肿瘤电切术（TURBT）患者内收肌痉挛的效果。方法学本随机对照研究包括240名年龄在30至70岁的成人患者，他们接受TURBT治疗膀胱外侧和后外侧壁肿瘤，他们符合美国麻醉医师协会的I级和II级标准。将患者分为两组：U组（n=120）包括使用超声引导技术进行ONB的患者，而UN组（n=120）包括使用神经刺激技术进行超声进行ONB的患者。块性能时间,内收肌抽搐/痉挛，内收肌力,比较患者和外科医生的满意度。P值<0.05被认为具有统计学意义。结果U组的平均阻滞时间（4.4±0.82分钟）明显少于UN组（6.55±0.37分钟）。与U组相比，手术期间，UN组的内收肌抽搐/痉挛明显减少(7.76%vs.20.35%,p=0.006),显著提高外科医生满意度(92.24%与79.65%,p=0.006),患者满意度显著提高(92.24%与79.65%,p=0.006),和相当的并发症（过度出血和轻微的膀胱损伤）和内收肌力阻滞后（p>0.05）。结论在超声引导下使用神经刺激技术的ONB具有较长的平均阻滞表现时间,更高的成功率，仅在超声引导下，外科医生满意度高于ONB。
