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COMPARISON OF OBTURATOR NERVE BLOCK TECHNIQUES IN TURBT

NCT07481123 · Status: COMPLETED · Phase: NA · Type: INTERVENTIONAL · Enrollment: 60

Last updated 2026-03-18

No results posted yet for this study

Summary

Bladder cancer is one of the most common cancers in older adults. The standard treatment for many bladder tumors is a surgical procedure called transurethral resection of bladder tumor (TUR-BT). During this operation, tumors located on the side wall of the bladder may trigger an involuntary leg movement known as the "obturator reflex." This reflex occurs when electrical stimulation during surgery activates the obturator nerve, causing sudden contraction of the inner thigh (adductor) muscles. Such muscle spasms can lead to serious complications, including incomplete tumor removal or bladder perforation.

To prevent this reflex, anesthesiologists perform an obturator nerve block (ONB), a procedure in which local anesthetic medication is injected around the nerve to temporarily stop its function. With advances in ultrasound technology, different ultrasound-guided techniques have been developed to perform this nerve block more safely and effectively.

There are two commonly used approaches. The first is the interfacial (distal) technique, in which two separate injections are performed to block the anterior and posterior branches of the obturator nerve. The second is the subpectineal (proximal) technique, in which the nerve is blocked with a single injection at a more proximal location, potentially using a smaller amount of local anesthetic.

The purpose of this study was to compare these two ultrasound-guided techniques in patients undergoing TUR-BT surgery. The aim of this study was to compare the effectiveness and safety of the subpectineal and interfacial obturator nerve block techniques in preventing adductor muscle spasm during surgery.

Sixty patients aged between 50 and 80 years who were scheduled for TUR-BT were randomly assigned to receive either the subpectineal or the interfacial obturator nerve block. The main outcome measured was the occurrence and severity of adductor muscle spasm during surgery. Secondary outcomes included the number of needle insertions, duration of anesthesia and surgery, and any complications related to the block.

The hypothesis of this study was that the subpectineal technique would provide comparable effectiveness in preventing adductor muscle spasm compared with the interfacial technique while requiring fewer injections and a lower volume of local anesthetic.

The results of this study may help determine the most effective and practical technique for preventing surgical complications during bladder tumor surgery.

Conditions

Interventions

PROCEDURE

Subpectineal Obturator Nerve Block

Ultrasound-guided single-injection obturator nerve block performed between the pectineus and obturator externus muscles using 10 mL of 0.375% bupivacaine.

PROCEDURE

Interfacial Obturator Nerve Block

Ultrasound-guided obturator nerve block performed with two separate injections between adductor muscle groups using 0.375% bupivacaine.

Sponsors & Collaborators

  • Yavuz Saygılı

    lead OTHER

Study Design

Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Model
PARALLEL

Eligibility

Min Age
50 Years
Max Age
80 Years
Sex
ALL
Healthy Volunteers
No

Timeline & Regulatory

Start
2022-08-01
Primary Completion
2022-12-31
Completion
2022-12-31

Countries

  • Turkey (Türkiye)

Study Locations

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Entities

Diseases

Read the full study record

This page highlights key information. For complete eligibility criteria, study locations, investigator contacts, and the full protocol, visit the original record on ClinicalTrials.gov.

View NCT07481123 on ClinicalTrials.gov