Femoral and Sciatic Nerve Blocks Added to Obturator Nerve Block for Prevention of Obturator Reflex
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.
Studieoversikt
Status
Status
Forhold
Forhold
Intervensjon / Behandling
Intervensjon / Behandling
Detaljert 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.
Studietype
Studietype
Registrering (Antatt)
Registrering
Fase
Fase
- Ikke aktuelt
Kontakter og plasseringer
Studiekontakt
Studiekontakt
- Navn: Tuna Ertürk, MD
- Telefonnummer: +905325010066
- E-post: tunaerturk22@yahoo.com
Studiesteder
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Istanbul, Tyrkia (Türkiye), 34668
- Sultan 2. Abdulhamid Han Training and Research Hospital
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Ta kontakt med:
- Hakan EMİRKADI, MD
- Telefonnummer: +905322609367
- E-post: hemirkadi@gmail.com
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Deltakelseskriterier
Kvalifikasjonskriterier
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
Tar imot friske frivillige
Kjønn som er kvalifisert for studier
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
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Forebygging
- Tildeling: Randomisert
- Intervensjonsmodell: Parallell tildeling
- Masking: Dobbelt
Antall våpen
Våpen og intervensjoner
Deltakergruppe / ArmDeltakergruppe / Arm |
Intervensjon / BehandlingIntervensjon / Behandling |
|---|---|
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Aktiv komparator: Obturator Nerve Block (ONB)
Patients will receive an ultrasound-guided obturator nerve block. |
Ultrasound-guided obturator nerve block will be performed. |
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Eksperimentell: 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. |
|
Eksperimentell: 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. |
Hva måler studien?
Primære resultatmål
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
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Number of Participants With at Least One Intraoperative Adductor Muscle Contraction
Tidsramme: On the day of surgery, during transurethral tumor resection
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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
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Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
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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
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|
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
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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
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Number of Participants With Bladder Wall Injury or Perforation
Tidsramme: On the day of surgery, during transurethral tumor resection
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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
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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
|
Samarbeidspartnere og etterforskere
Sponsor
Sponsor
Etterforskere
Etterforskere
- Hovedetterforsker: Tuna Ertürk, MD, University of Health Sciences Sultan 2. Abdulhamid Han Training and Research Hospital
Studierekorddatoer
Studer hoveddatoer
Studiestart (Antatt)
Studiestart
Primær fullføring (Antatt)
Primær fullføring
Studiet fullført (Antatt)
Studiet fullført
Datoer for studieregistrering
Først innsendt
Først innsendt
Først innsendt som oppfylte QC-kriteriene
Først innsendt som oppfylte QC-kriteriene
Først lagt ut (Faktiske)
Først lagt ut
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
Sist oppdatering lagt ut
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Sist bekreftet
Sist bekreftet
Mer informasjon
Begreper knyttet til denne studien
Andre studie-ID-numre
Andre studie-ID-numre
- 20-115
Plan for individuelle deltakerdata (IPD)
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