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

2 november 2026 uppdaterad av: 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.

Studieöversikt

Status

Har inte rekryterat ännu

Betingelser

Intervention / Behandling

Detaljerad beskrivning

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.

Studietyp

Interventionell

Inskrivning (Beräknad)

90

Fas

  • Inte tillämpbar

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studiekontakt

Studieorter

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

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

18 år till 90 år (Vuxen, Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Beskrivning

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

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Förebyggande
  • Tilldelning: Randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Dubbel

Vapen och interventioner

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

Patients will receive an ultrasound-guided obturator nerve block.
Procedur: Obturator Nerve Block

Ultrasound-guided obturator nerve block will be performed.
Experimentell: ONB + FNB

Patients will receive ultrasound-guided obturator and femoral nerve blocks.
Procedur: Obturator Nerve Block

Ultrasound-guided obturator nerve block will be performed.

Procedur: Femoral Nerve Block

Ultrasound-guided femoral nerve block will be performed in addition to obturator nerve block.
Experimentell: ONB + FNB + SNB

Patients will receive ultrasound-guided obturator, femoral, and sciatic nerve blocks.
Procedur: Obturator Nerve Block

Ultrasound-guided obturator nerve block will be performed.

Procedur: Femoral Nerve Block

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

Procedur: Sciatic Nerve Block

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

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Number of Participants With at Least One Intraoperative Adductor Muscle Contraction
Tidsram: 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

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Number of Participants With Severe Intraoperative Adductor Muscle Contractions
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

Tuna Erturk

Utredare

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

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Beräknad)

2 november 2026

Primärt slutförande (Beräknad)

2 februari 2027

Avslutad studie (Beräknad)

2 februari 2027

Studieregistreringsdatum

Först inskickad

2 november 2026

Först inskickad som uppfyllde QC-kriterierna

2 november 2026

Första postat (Faktisk)

6 november 2026

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

6 november 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

2 november 2026

Senast verifierad

1 november 2026

Mer information

Termer relaterade till denna studie

Nyckelord

Andra studie-ID-nummer

  • 20-115

Plan för individuella deltagardata (IPD)

Planerar du att dela individuella deltagardata (IPD)?

NEJ

Läkemedels- och apparatinformation, studiedokument

Studerar en amerikansk FDA-reglerad läkemedelsprodukt

Nej

Studerar en amerikansk FDA-reglerad produktprodukt

Nej

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