Safety and Efficacy of Transurethral Resection of Bladder Tumor Comparing Spinal Anesthesia with Spinal Anesthesia with an Obturator Nerve Block: A Systematic Review and Meta-analysis

Krishan, Anil; Bruce, Angus; Khashaba, Shehab; Abouelela, Mohamed A.; Ehsanullah, Syed

doi:10.1089/end.2020.1054

Cited by 9 publications

(8 citation statements)

References 37 publications

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“…A previous meta‐analysis showed that spinal anesthesia combined with various ONB methods reduced the occurrence of obturator nerve reflex more effectively compared to spinal anesthesia alone 36 . However, there is insufficient evidence regarding the efficacy of two or more ONB approaches during TURBT.…”

Section: Discussionmentioning

confidence: 99%

Comparison of different methods of obturator nerve block in transurethral resection of bladder tumors: A systematic review and network meta‐analysis

Gao

Zhang

et al. 2022

Cancer Medicine

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Background: Bladder cancer is the most common malignancy of the urinary system, and accounts for 3% of newly diagnosed tumors. Transurethral resection of bladder tumor plays a key role in treating bladder cancer, among which one of the most serious complications is bladder perforation caused by obturator nerve reflex. Obturator nerve reflex can be prevented by inducing obturator nerve block after lumbar anesthesia. However, No study so far has compared the inhibitory effect of different obturator nerve block approaches on intraoperative obturator nerve reflex and bladder perforation. Method:In this study, we conducted a network meta-analysis (NMA) of studies comparing the efficacy of different obturator nerve block approaches performed after lumbar anesthesia in operation. Result:The distal obturator nerve block guided by peripheral nerve stimulator is the best approach for preventing obturator reflex. The proximal obturator nerve block guided by ultrasound is the best approach for preventing bladder perforation. Conclusion:Spinal anesthesia combined with the distal obturator nerve block guided by peripheral nerve stimulator is the most optimal approach to prevent the obturator nerve reflex. But the doctor should choose the appropriate anesthesia method according to the patient's general condition, tumor location, and doctor's proficiency in puncture techniques. K E Y W O R D S bladder cancer, lumbar anesthesia, obturator nerve block, transurethral resection of bladder tumor | 5421 WU et al.

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Section: Discussionmentioning

confidence: 99%

Comparison of different methods of obturator nerve block in transurethral resection of bladder tumors: A systematic review and network meta‐analysis

Gao

Zhang

et al. 2022

Cancer Medicine

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“…In addition, the prolongation of the maternal survival process is also considered an independent influencing factor of intrapartum fever. Therefore, the avoidance of prolonged labor is considered an effective measure for body temperature management [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Impact of Intraspinal Nerve Block Anesthesia on Intrapartum Fever and the Neonate

Wang

Chang

Chen

2022

Evidence-Based Complementary and Alternative Medicine

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Objective. To evaluate the impact of intraspinal nerve block anesthesia on intrapartum fever and the neonate. Methods. In this prospective study, between October 2019 and December 2020, 90 eligible primiparous women enrolled in the obstetrics and gynecology department of our hospital for delivery were recruited and assigned via the random number table method at a ratio of 1 : 1 to either an analgesic group given intraspinal nerve block anesthesia for labor or a nonanalgesic group without anesthesia for labor. Outcome measures included intrapartum body temperature, cases of intrapartum fever, Apgar scores of neonates, visual analogue scale (VAS) scores, delivery mode, and indomethacin use. Results. Intraspinal nerve block anesthesia was associated with a higher body temperature at 4 h and 5 h after analgesia and more cases of intrapartum fever versus no anesthesia ( P < 0.05 ). There were no significant differences in the Apgar scores between the two groups ( P > 0.05 ). Participants given intraspinal nerve block anesthesia had lower VAS scores during labor versus those without anesthesia ( P < 0.05 ). The differences in the delivery mode between the two groups were not significant ( P > 0.05 ). Intraspinal nerve block anesthesia resulted in a significantly higher demand for indomethacin versus no anesthesia ( P < 0.05 ). Conclusion. Intraspinal nerve block anesthesia is clinically effective in labor analgesia but may cause increased body temperature or even overt clinical fever, so close clinical observation of maternal temperature changes is required to mitigate the effects of anesthesia on the mothers. No adverse consequences of intraspinal nerve block anesthesia on the newborns were reported in this study.

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“…Outra complicação urológica que acomete grande parcela da população mundial é o câncer de bexiga, onde procedimentos cirúrgicos são fundamentais para diagnóstico e tratamento destes na forma de ressecção transuretral de tumor de bexiga (TURBT). Sendo mais prevalente em pacientes após os 60 anos (média de 73 anos) e considerando as comorbidades relacionadas a idade, a AS é a escolha para este grupo de pacientes, visto que a AG pode acarretar o aumento do risco de complicações cardiorrespiratórias (Krishan et al, 2021). Krishan et al, (2020) investigaram através de uma meta-análise se a AS com bloqueio do nervo obturador (ONB) é eficaz para TURBT durante a pandemia de coronavírus, comparando os resultados de TURBT com AS e AS associado ao ONB.…”

Section: Urologiaunclassified

“…Ainda, não foi encontrado na literatura evidências da toxicidade do AL utilizado. Diante disto, os autores concluem que a AS apresenta vantagens durante a pandemia da COVID-19 e deve ser preferida sempre que possível (Krishan et al, 2021).…”

Section: Urologiaunclassified

Anestesia regional como alternativa para procedimentos médicos na pandemia da COVID-19

Segundo

Pavanello

Paiva

2021

RSD

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A pandemia de coronavírus (SARS-CoV-2) impactou significativamente os sistemas de saúde e desafiou a equipe multidisciplinar, sendo considerado um problema de saúde pública global. Diversas estratégias foram sugeridas visando a segurança e minimizar a exposição dos profissionais de saúde e pacientes hospitalizados ao vírus, sendo uma destas evitar procedimentos geradores de aerossóis durante os procedimentos cirúrgicos, como o manejo das vias aéreas. Diante disto, a anestesias regional e local tornaram-se como uma alternativa viável, eficaz e segura a anestesia geral, desempenhando um papel importante durante o surto da COVID-19, quando aplicável. Dentre as vantagens pode-se citar a não geração de aerossóis, analgesia pós-operatória, redução de náuseas e vômitos e também, de complicações cardiorrespiratórias. Este estudo objetiva investigar a aplicação da anestesia regional nas diversas especialidades médicas durante a pandemia de coronavírus avaliando os resultados do emprego desta. Foi realizada uma busca nas bases de dados Pubmed, Web of Science (todas as bases de dados), Scopus, Embase e Cochrane Library utilizando os termos de busca “SARS-CoV-2”, “COVID-19”, “Anesthesia, Local” e “Anesthetics, Local” onde 49 referências foram incluídas. Os estudos demonstram bons resultatos nas técnicas empregadas e possibilitam uma alternativa de tratamento em diversos campos cirúrgicos de maneira segura. Dessa forma a anestesias regional e local são adequadas e viáveis para procedimentos médicos cirúrgicos e constituem uma boa alternativa a anestesia geral podendo ser aplicadas em diferentes especialidades cirúrgicas.

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Safety and Efficacy of Transurethral Resection of Bladder Tumor Comparing Spinal Anesthesia with Spinal Anesthesia with an Obturator Nerve Block: A Systematic Review and Meta-analysis

Cited by 9 publications

References 37 publications

Comparison of different methods of obturator nerve block in transurethral resection of bladder tumors: A systematic review and network meta‐analysis

Comparison of different methods of obturator nerve block in transurethral resection of bladder tumors: A systematic review and network meta‐analysis

Impact of Intraspinal Nerve Block Anesthesia on Intrapartum Fever and the Neonate

Anestesia regional como alternativa para procedimentos médicos na pandemia da COVID-19

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