Current Intensity for the Obturator Nerve Block

Bladder Tumor Clinical Trial

— Current_ONB  

Official title:

The Difference in the Current Intensity for the Obturator Nerve Block According to the Presence or Absence of Neuromuscular Blockage

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT05872451
• Other study ID #: ONB
• Status: Recruiting
• Phase: N/A
• Start date: July 1, 2023
• Est. completion date: April 30, 2024

Study information

• Verified date: August 2023
• Source: Chosun University Hospital
• Contact: Ki Tae Jung, M.D., Ph.D.
• Phone: +82-62-220-3223
• Email: mdmole[@]chosun.ac.kr
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The purpose of the present study was to find out the difference in current intensity required for nerve stimulation according to the presence or absence of neuromuscular blockade during the obturator nerve block procedure for TURP.

Description:

During the transurethral resection of bladder tumors (TURBT) procedure under spinal anesthesia, the obturator nerve block is required to prevent the accidental movement of adductor longus muscles by electrical stimulation. However, during general anesthesia, the contraction of the adductor longus muscle would be lost due to deep neuromuscular blockade. However, some reports showed that the contraction of the adductor longus muscle occurs even in the deep neuromuscular blockade.

The current intensity for the nerve stimulation during nerve block is 0.3--0.5 mA when the needle tip is near the nerve. However, it is still unknown what current intensity is required to show the contraction of the adductor longus muscle when the patient is in a deep neuromuscular blockade.

Therefore, in this study, investigators aimed to determine the difference in current intensity required for nerve stimulation according to the presence or absence of neuromuscular blockade during obturator nerve block for TURP. In addition, investigators aimed to determine that the obturator nerve block is required during the TURP procedure in patients with deep neuromuscular blockade during general anesthesia.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 30
• Est. completion date: April 30, 2024
• Est. primary completion date: April 30, 2024
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Patients undergoing TURP procedure

Exclusion Criteria:

• Patients with anatomical or functional anomaly in the upper airways

• Patients with neuromuscular disease

• Patients with hip joint disorders

• BMI of < 18.5 or > 30.0 kg/m2

Related Conditions & MeSH terms

• Bladder Tumor
• Urinary Bladder Neoplasms

Intervention

Drug:
• Rocuronium Bromide
After measuring the initial current intensity, quantitative neuromuscular blockade monitoring is applied, and rocuronium (0.6 mg/kg) is administered.

Diagnostic Test:
• Nerve stimulator
Measuring the minimum current intensity for the stimulation of the obturator nerve to show the contraction of the adductor longus muscle.

Locations

Country	Name	City	State
Korea, Republic of	Chosun University Hospital	Gwangju

Sponsors (1)

Lead Sponsor	Collaborator
Chosun University Hospital

Country where clinical trial is conducted

Korea, Republic of, 

References & Publications (1)

Koo CH, Ryu JH. Anesthetic considerations for urologic surgeries. Korean J Anesthesiol. 2020 Apr;73(2):92-102. doi: 10.4097/kja.19437. Epub 2019 Dec 17. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Initial current intensity	The current intensity for the stimulation of the obturator nerve starts at 1.0 mA (using the sequential electrical nerve stimulation mode), and the needle is advanced gradually to the location where the stimulus response occurs at 0.3-0.5 mA. After fixing the needle position in a position where contraction of the adductor longus muscle responds to the minimum current intensity, measure the current intensity.	About 5 minutes after starting obturator nerve block procedure
Primary	Final current intensity	After administration of rocuronium (0.6 mg/kg), when the train-of-four count becomes 0, the current intensity for the stimulation of the obturator nerve is increased until the contraction of the adductor longus muscle occurs. The current intensity is measured when the contraction of the adductor longus muscle occurs.	About 10 minutes after starting obturator nerve block procedure
Secondary	Current intensity after the administration of rocuronium (0.6 mg/kg)	After administration of rocuronium (0.6 mg/kg), the quantitative neuromuscular blockade monitoring using train-of-four is observed with 12 seconds interval. At each time point, the current intensity for the obturator nerve is increased until the contraction of the adductor longus muscle occurs. The current intensity at each time point is measured.	Between 5 minutes and 10 minutes after starting obturator nerve block procedure