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Peer-reviewedCC BY-NC-SASaudi journal of anaesthesia

Ultrasound with nerve stimulation versus ultrasound alone for obturator nerve block in transurethral resection of bladder tumor: A systematic review and meta-analysis.

  • Qun Hu1
  • Luping Gan1
  • Cui Ouyang2
  • Li Peng3
  • Changgen Zhong1
  • Shengqiang Wang1
  1. 1Department of Anesthesiology, The People's Hospital of Yichun City, Jiangxi, China.
  2. 2Department of Nursing, The People's Hospital of Yichun City, Jiangxi, China.
  3. 3Department of Neurology, The People's Hospital of Yichun City, Jiangxi, China.
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Abstract

Background

The obturator nerve block (ONB) is commonly used during transurethral resection of bladder tumor (TURBT) to prevent adductor spasm. Both ultrasound (US)-guided and nerve stimulation (NS) techniques are available, but whether adding NS to US improves block outcomes remains debated.Methods

We searched PubMed, Cochrane Library, and Web of Science up to 6 April 2026. The rate of adductor spasm prevention, block performance time, onset time, number of needle passes, patient and surgeon satisfaction, and complications were evaluated. Pooled odds ratios (OR) or mean differences (MD) with 95% confidence intervals (CI) were calculated.Results

Five randomized controlled trials (RCTs) comprising 451 patients were analyzed. The US + NS group significantly improved block rate of adductor spasm prevention compared to US alone (OR = 3.20, 95% CI: 1.72-5.93, P < 0.001; I² =0%), but required longer performance time (MD = 1.99 min, 95% CI: 1.51-2.47, P < 0.001; I² =91%). No differences were found in needle passes or onset time. Complications were rare and comparable.Conclusions

Combining nerve stimulation with US guidance for ONB significantly improves rate of adductor spasm prevention and patient/surgeon satisfaction compared to US guidance alone, although with a longer block performance time. The two techniques are similar in onset time and needle passes. US + NS is recommended for ONB during TURBT.

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Cite

BibTeXRIS
BibTeX
@article{hu2026ultrasound,
  title = {{Ultrasound with nerve stimulation versus ultrasound alone for obturator nerve block in transurethral resection of bladder tumor: A systematic review and meta-analysis.}},
  author = {Qun Hu and Luping Gan and Cui Ouyang and Li Peng and Changgen Zhong and Shengqiang Wang},
  journal = {Saudi journal of anaesthesia},
  year = {2026},
  month = oct,
  doi = {10.4103/sja.sja_368_26},
  url = {https://europepmc.org/article/MED/42960054},
  note = {CC BY-NC-SA},
}
RIS
TY  - JOUR
TI  - Ultrasound with nerve stimulation versus ultrasound alone for obturator nerve block in transurethral resection of bladder tumor: A systematic review and meta-analysis.
AU  - Qun Hu
AU  - Luping Gan
AU  - Cui Ouyang
AU  - Li Peng
AU  - Changgen Zhong
AU  - Shengqiang Wang
PY  - 2026
DA  - 2026/10/01
JO  - Saudi journal of anaesthesia
DO  - 10.4103/sja.sja_368_26
UR  - https://europepmc.org/article/MED/42960054
AB  - Background  The obturator nerve block (ONB) is commonly used during transurethral resection of bladder tumor (TURBT) to prevent adductor spasm. Both ultrasound (US)-guided and nerve stimulation (NS) techniques are available, but whether adding NS to US improves block outcomes remains debated.Methods  We searched PubMed, Cochrane Library, and Web of Science up to 6 April 2026. The rate of adductor spasm prevention, block performance time, onset time, number of needle passes, patient and surgeon satisfaction, and complications were evaluated. Pooled odds ratios (OR) or mean differences (MD) with 95% confidence intervals (CI) were calculated.Results  Five randomized controlled trials (RCTs) comprising 451 patients were analyzed. The US + NS group significantly improved block rate of adductor spasm prevention compared to US alone (OR = 3.20, 95% CI: 1.72-5.93, P < 0.001; I² =0%), but required longer performance time (MD = 1.99 min, 95% CI: 1.51-2.47, P < 0.001; I² =91%). No differences were found in needle passes or onset time. Complications were rare and comparable.Conclusions  Combining nerve stimulation with US guidance for ONB significantly improves rate of adductor spasm prevention and patient/surgeon satisfaction compared to US guidance alone, although with a longer block performance time. The two techniques are similar in onset time and needle passes. US + NS is recommended for ONB during TURBT.
SN  - 1658-354X
SN  - 0975-3125
ER  -