The role of succinylcholine in the prevention of the obturator nerve reflex during transurethral resection of bladder tumors.
OBJECTIVE
To present our 8 year experience in the prevention of the obturator nerve reflex during transurethral resection of bladder tumors.


METHODS
This study was performed in Ataturk University Hospital between 1999 and 2007. We retrospectively reviewed the records of 89 patients with inferolateral bladder tumors, who underwent transurethral resection under epidural or general anesthesia and requested obturator nerve reflex inhibition. Epidural anesthesia was administered to 57 patients, while the remaining 32 patients underwent general anesthesia via mask; and succinylcholine was administered prior to resection.


RESULTS
Of the 57 patients received epidural anesthesia, 18 were diagnosed as inferolateral bladder tumors during endoscopy and had to undergo general anesthesia. Obturator nerve block was attempted preoperatively in 39 patients. However, a nerve identification failure, a hematoma, and 4 obturator nerve reflex events, despite the block, were observed and these patients were subjected to general anesthesia with succinylcholine. Fifty-six patients (32 patients initially had general anesthesia and 24 converted from epidural to general anesthesia) were all given succinylcholine prior to resection.


CONCLUSIONS
Due to its mechanism of action, succinylcholine is completely effective and represents a simple alternative to obturator nerve block. No contraction was observed in any patient given succinylcholine.
Cesur
Mehmet
M
Department of Anesthesiology, Medical Faculty, Ataturk University, Erzurum, Turkey.
Erdem
Ali F
AF
Alici
Haci A
HA
Yapanoglu
Turgut
T
Yuksek
Mustafa S
MS
Aksoy
Yilmaz
Y
D000767:Anesthesia, Epidural; D000768:Anesthesia, General; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009467:Neuromuscular Depolarizing Agents / Q000008:administration & dosage*; D009776:Obturator Nerve / Q000187:drug effects*; D012018:Reflex / Q000187:drug effects*; D012189:Retrospective Studies; D013390:Succinylcholine / Q000008:administration & dosage*; D001749:Urinary Bladder Neoplasms / Q000601:surgery*
D009467:Neuromuscular Depolarizing Agents; D013390:Succinylcholine