To investigate the preventive effect of local anesthesia of bladder puncture on obturator nerve reflex in transurethral resection of bladder lateral wall tumor.

On the basis of epidural anesthesia, the patients were divided into observation group and control group according to whether local anesthesia of bladder puncture was performed. There were 23 cases in observation group and 19 cases in control group. In the observation group, the bladder was first filled with about 400 ml, and then the bladder was punctured with 18 G percutaneous renal puncture needle at 2 cm of the upper edge of the pubis. Under the monitoring of the electrocision, the puncture needle was inclined to the affected side, and the needle was punctured at 1cm from the upper, lower, left and right sides to the edge of the base of the tumor, and the needle tip reached out of the bladder muscle layer, and the needle core was withdrawn. After no blood was drawn back, about 5 ml of 1% lidocaine was injected through the needle sheath. Finally, 10 ml of 1% lidocaine was injected 2 cm above the ureteral opening to block the obturator nerve. Then the tumor was resected by conventional methods. In the control group, no local anesthesia was used. During the removal of the lateral wall tumor, the methods of reducing the fluid in the bladder, reducing the extended distance of the electrocautery ring, reducing the height of the lower limbs on the affected side, and electrocautery of the bladder wall around the tumor were used.

Obturator nerve reflex occurred in 2 cases of the observation group and 13 cases of the control group (P<0.01). In the observation group /control group, there were 0/3 cases of bladder perforation, 6/5 cases of indwelling catheter for more than 7 days, and 0/2 cases of secondary electric resection, (all P>0.05).

The local anesthesia of bladder puncture is simple and effective, which can effectively avoid the occurrence of complications such as obturator nerve reflex, increase the safety of operation and improve the effect of operation.