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Femoral and Sciatic Nerve Blocks Added to Obturator Nerve Block for Prevention of Obturator Reflex

2. november 2026 opdateret af: Tuna Erturk

Comparison of the Efficacy of Femoral and Sciatic Nerve Blocks Added to Obturator Nerve Block in Preventing the Obturator Reflex

This prospective, randomized controlled study aims to evaluate whether adding femoral and sciatic nerve blocks to obturator nerve block improves the prevention of obturator reflex during transurethral resection of bladder tumors under spinal anesthesia.

Ninety patients will be randomly assigned to three groups: obturator nerve block alone, obturator plus femoral nerve blocks, or obturator plus femoral and sciatic nerve blocks. Adductor muscle contractions, surgeon satisfaction, procedure duration, and complications will be evaluated.

Studieoversigt

Detaljeret beskrivelse

This single-center, prospective, randomized controlled study will include 90 patients aged 18-90 years with American Society of Anesthesiologists (ASA) physical status I-III who are scheduled for transurethral resection of unilateral lateral bladder wall tumors under spinal anesthesia.

Eligible patients will be randomly allocated into three groups of 30 patients each:

Group 1: Obturator nerve block (ONB) alone.

Group 2: Obturator nerve block combined with femoral nerve block (ONB + FNB).

Group 3: Obturator nerve block combined with femoral and sciatic nerve blocks (ONB + FNB + SNB).

The nerve blocks will be performed using ultrasound guidance according to the study protocol.

During surgery, the occurrence and severity of adductor muscle contractions associated with the obturator reflex will be recorded. Contractions will be classified as absent, mild, or severe according to their interference with the surgical procedure. The total number of contractions will also be documented.

Additional assessments will include block procedure duration, surgical duration, surgeon satisfaction using a 0-10 numerical scale, conversion to general anesthesia, bleeding, bladder injury, perforation, blood transfusion, and complications related to the nerve blocks.

The study aims to determine whether adding femoral and sciatic nerve blocks to obturator nerve block improves the prevention of obturator reflex during transurethral bladder tumor resection.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

90

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Studiesteder

      • Istanbul, Tyrkiet (Türkiye), 34668
        • Sultan 2. Abdulhamid Han Training and Research Hospital
        • Kontakt:

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år til 90 år (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • Patients aged 18-90 years.
  • American Society of Anesthesiologists (ASA) physical status I-III.
  • Patients scheduled for transurethral resection of unilateral lateral or inferolateral bladder wall tumors under spinal anesthesia.
  • Patients providing informed consent personally or through a legally authorized representative.
  • No known hypersensitivity to the medications used in the study.
  • No infection or anatomical deformity at the nerve block sites.
  • No antithrombotic treatment and normal coagulation parameters.

Exclusion Criteria:

  • Age younger than 18 or older than 90 years.
  • ASA physical status IV or higher.
  • Absence of informed consent.
  • Hypersensitivity to the study medications or their components.
  • Infection or anatomical deformity at the nerve block sites.
  • Antithrombotic treatment.
  • Abnormal coagulation parameters.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Forebyggelse
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Dobbelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Aktiv komparator: Obturator Nerve Block (ONB)

Patients will receive an ultrasound-guided obturator nerve block.

Ultrasound-guided obturator nerve block will be performed.

Eksperimentel: ONB + FNB

Patients will receive ultrasound-guided obturator and femoral nerve blocks.

Ultrasound-guided obturator nerve block will be performed.

Ultrasound-guided femoral nerve block will be performed in addition to obturator nerve block.

Eksperimentel: ONB + FNB + SNB

Patients will receive ultrasound-guided obturator, femoral, and sciatic nerve blocks.

Ultrasound-guided obturator nerve block will be performed.

Ultrasound-guided femoral nerve block will be performed in addition to obturator nerve block.

Ultrasound-guided sciatic nerve block will be performed in addition to obturator and femoral nerve blocks.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Number of Participants With at Least One Intraoperative Adductor Muscle Contraction
Tidsramme: On the day of surgery, during transurethral tumor resection

Participants experiencing at least one adductor muscle contraction during transurethral bladder tumor resection will be recorded. The number and proportion of affected participants will be compared across the three groups.

On the day of surgery, during transurethral tumor resection

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Number of Participants With Severe Intraoperative Adductor Muscle Contractions
Tidsramme: On the day of surgery, during transurethral tumor resection

Adductor muscle contractions will be classified as severe if they interfere with the surgeon during resection. The number of participants experiencing at least one severe contraction will be recorded and compared across the three groups.

On the day of surgery, during transurethral tumor resection
Surgeon Satisfaction Score
Tidsramme: At the end of surgery, on the day of the procedure

Surgeon satisfaction will be assessed using a numerical rating scale from 0 (very poor) to 10 (excellent). Scores will be compared across the three groups.

At the end of surgery, on the day of the procedure
Total Number of Intraoperative Adductor Muscle Contractions
Tidsramme: On the day of surgery, during transurethral tumor resection

The total number of adductor muscle contractions occurring during transurethral bladder tumor resection will be recorded for each participant and compared across the three groups.

On the day of surgery, during transurethral tumor resection
Number of Participants With Bladder Wall Injury or Perforation
Tidsramme: On the day of surgery, during transurethral tumor resection

The occurrence of bladder wall injury or perforation during transurethral bladder tumor resection will be recorded and compared across the three groups.

On the day of surgery, during transurethral tumor resection
Number of Participants With Inability to Continue Surgery Due to Adductor Muscle Contraction
Tidsramme: On the day of surgery, during transurethral tumor resection

Inability to continue surgical resection due to intraoperative adductor muscle contraction will be recorded and compared across the three groups.

On the day of surgery, during transurethral tumor resection

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Efterforskere

  • Ledende efterforsker: Tuna Ertürk, MD, University of Health Sciences Sultan 2. Abdulhamid Han Training and Research Hospital

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

2. november 2026

Primær færdiggørelse (Anslået)

2. februar 2027

Studieafslutning (Anslået)

2. februar 2027

Datoer for studieregistrering

Først indsendt

2. november 2026

Først indsendt, der opfyldte QC-kriterier

2. november 2026

Først opslået (Faktiske)

6. november 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

6. november 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

2. november 2026

Sidst verificeret

1. november 2026

Mere information

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