Comparison of Interfascial Injection Versus Subpectineal Injection on Ultrasound-guided Obturator Nerve Block

Study Overview
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Brief Summary
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This study aimed to assess the effectiveness of the ultrasound-guided interfascial injection approach with the subpectineal injection technique for obturator nerve block in bladder cancers undergoing transurethral resection of bladder tumor (TURBT) under spinal anesthesia.

Official Title
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Comparison of Interfascial Injection Versus Subpectineal Injection on Ultrasound-guided Obturator Nerve Block

Conditions
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Bladder Neoplasm

Intervention / Treatment
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* Procedure: Interfascial Injection
* Procedure: Subpectineal Injection


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Lateral wall bladder tumour ASA I-II patients Exclusion Criteria: Contraindications for spinal anesthesia, Tumors that disrupt the integrity of the bladder, Coagulation disorders, Uncooperative patients, Allergy to local anesthetics.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Ultrasound guided interfascial obturator nerve block<br>In supine position, ultrasound probe will be placed on inguinal region, 2-3 cm below to the inguinal crease. Patients in this group will receive interfascial obturator nerve block under ultrasound guidance. | Procedure: Interfascial Injection<br>* Interfascial Injection on Ultrasound-guided Obturator Nerve Block<br>|
| Experimental: Ultrasound guided subpectineal obturator nerve block<br>In supine position, the ultrasound probe will be placed on in inguinal region, 1-2 cm below to the inguinal crease to identiy the subpectineal area. Patients in this group will receive subpectineal obturator nerve block under ultrasound guidance. | Procedure: Subpectineal Injection<br>* Subpectineal Injection on Ultrasound-guided Obturator Nerve Block<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Success rate of obturatr nerve block | The success or fail of the obturator nerve block will be conformed using nerve stimulator. Detecting muscles twitch will br considered to be a fail. | Peroperative period | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of adductor muscle spazms | Number of adductor muscle spazms in each group will be noted during the intraoperative period. | Intraoperative period | 
| Sensory block | Sensory block area will be evaluated by a pin prick at in the dermatomal areas related obturator nerve and branches. | 30 minutes after the intervention | 
| Patient satisfaction | Changes in overall satisfaction will be assessed using a 5 point Likert Scale ( 1-very dissatisfied, 2- dissatisfied, 3- neutral, 4-satisfied, 5 - very satisfied | Peroperative period | 
| Procedure time | Block performance time will be recorded from the time the first ultrasound image is obtained until the procedure is completed | During the procedure | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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obturator nerve block, ultrasound guided block, bladder tumor