{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T08:09:27Z","timestamp":1784534967008,"version":"3.55.0"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"\n Background and Aims:<\/jats:title>\n Adductor jerk during transurethral resection of bladder tumour (TURBT) is a common complication caused by obturator nerve stimulation, particularly in tumours located on the lateral or posterolateral bladder wall. Obturator nerve block (ONB) is widely used to prevent this complication. The pericapsular nerve group (PENG) block is a newer regional technique that may also reduce adductor jerk by blocking branches of the obturator and accessory obturator nerves. This study compared the efficacy of ultrasound-guided PENG block and ONB in preventing adductor jerk during TURBT.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n This prospective, single-blinded, randomised study included patients undergoing TURBT for posterolateral bladder tumours under spinal anaesthesia. Patients received either ultrasound-guided ONB or PENG block. The primary outcome was the prevention of adductor jerk. Secondary outcomes included conversion to general anaesthesia, bladder perforation, postoperative pain scores, and quadriceps muscle strength.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Sixty-two patients were analysed, with 31 patients in each group. The incidence of adductor jerk was similar between groups using Fisher\u2019s exact test (\n P<\/jats:italic>\n = 1.000). Numerical Rating Scale scores at 6 hours were significantly lower in the PENG block group (median: 3.00 [2.00\u20133.00]) compared to the ONB group (median: 4.00 [3.00\u20134.00]), and this difference was statistically significant (Mann\u2013Whitney U = 224,\n P<\/jats:italic>\n < 0.001). Quadriceps muscle strength at 6 hours was comparable between groups with a median score of 5.00 in both groups, and the difference was not statistically significant (Mann\u2013Whitney U = 418,\n P<\/jats:italic>\n = 0.130). No bladder perforation was observed in either group.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Ultrasound-guided PENG block is comparable to ONB in preventing adductor jerk during TURBT and provides better postoperative analgesia.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/ija.ija_417_26","type":"journal-article","created":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T14:00:18Z","timestamp":1784383218000},"page":"814-820","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of efficacy of ultrasound-guided obturator nerve block versus pericapsular nerve group block in preventing adductor jerk in patients undergoing transurethral resection of postero-lateral bladder mass under spinal anaesthesia: A randomised, single-blinded, controlled study"],"prefix":"10.4103","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0065-0639","authenticated-orcid":false,"given":"Swati","family":"Vijapurkar","sequence":"first","affiliation":[{"name":"Department of Anesthesia and Critical Care, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1467-372X","authenticated-orcid":false,"given":"Subrata K","family":"Singha","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Critical Care, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7497-3920","authenticated-orcid":false,"given":"Jakkireddy","family":"Sravani","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Critical Care, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7472-9580","authenticated-orcid":false,"given":"Gade","family":"Sandeep","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Critical Care, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,7,21]]},"reference":[{"key":"R1-20260720","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1159\/000447223","article-title":"Avoiding the obturator jerk during TURBT","volume":"12","author":"Panagoda","year":"2018","journal-title":"Curr Urol"},{"key":"R2-20260720","doi-asserted-by":"crossref","first-page":"101","DOI":"10.4103\/0259-1162.184613","article-title":"Obturator nerve block in transurethral resection of bladder tumour: A comparative study by two techniques","volume":"11","author":"Sharma","year":"2017","journal-title":"Anesth Essays Res"},{"key":"R3-20260720","doi-asserted-by":"crossref","first-page":"118","DOI":"10.5455\/medarh.2023.77.118-122","article-title":"Obturator nerve block for transurethral resection of bladder tumours","volume":"77","author":"Gavrilovska-Brzanov","year":"2023","journal-title":"Med Arch"},{"key":"R4-20260720","doi-asserted-by":"crossref","first-page":"3056","DOI":"10.21037\/tau.2019.09.38","article-title":"Transurethral resection of bladder tumour (TURBT)","volume":"9","author":"Kim","year":"2020","journal-title":"Transl Androl Urol"},{"key":"R5-20260720","first-page":"e65859","article-title":"Efficacy and safety of obturator nerve block in transurethral resection of bladder tumours: A comprehensive review","volume":"16","author":"Rahane","year":"2024","journal-title":"Cureus"},{"key":"R6-20260720","doi-asserted-by":"crossref","first-page":"1357","DOI":"10.36347\/sasjs.2024.v10i12.002","article-title":"Efficacy of USG guided obturator block to prevent obturator jerk during TURBT operation","volume":"12","author":"Haque","year":"2024","journal-title":"SAS J Surg"},{"key":"R7-20260720","doi-asserted-by":"crossref","first-page":"2191","DOI":"10.1001\/jama.2013.281053","article-title":"World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects","volume":"310","year":"2013","journal-title":"JAMA"},{"key":"R8-20260720","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1111\/anae.14569","article-title":"A review of ASA physical status-Historical perspectives and modern developments","volume":"74","author":"Mayhew","year":"2019","journal-title":"Anaesthesia"},{"key":"R9-20260720","doi-asserted-by":"crossref","first-page":"1253","DOI":"10.1093\/pm\/pnaa448","article-title":"Obturator nerve blockade vs. neuromuscular blockade for the prevention of adductor spasm in patients undergoing transurethral resection of bladder tumors: A randomized controlled trial","volume":"22","author":"Sober\u00f3n","year":"2021","journal-title":"Pain Med"},{"key":"R10-20260720","doi-asserted-by":"crossref","first-page":"c332","DOI":"10.1136\/bmj.c332","article-title":"CONSORT 2010 statement: Updated guidelines for reporting parallel group randomised trials","volume":"340","author":"Schulz","year":"2010","journal-title":"BMJ"},{"key":"R11-20260720","doi-asserted-by":"crossref","first-page":"E117","DOI":"10.5489\/cuaj.3037","article-title":"A minimally invasive approach to transperitoneal perforation of the bladder during bladder tumour resection","volume":"10","author":"Bishay","year":"2016","journal-title":"Can Urol Assoc J"},{"key":"R12-20260720","first-page":"e22365","article-title":"Is obturator nerve block effective as spinal anesthesia in preventing adductor spasms in general anesthesia without muscle relaxants?","volume":"14","author":"Guney","year":"2022","journal-title":"Cureus"},{"key":"R13-20260720","doi-asserted-by":"crossref","first-page":"411","DOI":"10.4103\/0259-1162.194580","article-title":"Obturator nerve block in transurethral resection of bladder tumour: A comparison of ultrasound-guided technique versus ultrasound with nerve stimulation technique","volume":"11","author":"Shah","year":"2017","journal-title":"Anesth Essays Res"},{"key":"R14-20260720","doi-asserted-by":"crossref","first-page":"8490462","DOI":"10.1155\/2022\/8490462","article-title":"A systematic review and meta-analysis comparing the safety and efficacy of spinal anesthesia and spinal anesthesia combined with obturator nerve block in transurethral resection of bladder tumors","volume":"2022","author":"Deng","year":"2022","journal-title":"Emerg Med Int"},{"key":"R15-20260720","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/j.jclinane.2019.08.034","article-title":"A novel indication of pericapsular nerve group (PENG) block: Prevention of adductor muscle spasm","volume":"60","author":"Ahiskalioglu","year":"2020","journal-title":"J Clin Anesth"},{"key":"R17-20260720","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1186\/s42077-022-00227-0","article-title":"Pericapsular nerve group (PENG) block\u2014A scoping review","volume":"14","author":"Kaur","year":"2022","journal-title":"Ain-Shams J Anesthesiol"},{"key":"R18-20260720","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1136\/rapm-2020-102315","article-title":"Pericapsular nerve group (PENG) block provides improved short-term analgesia compared with the femoral nerve block in hip fracture surgery: A single-center double-blinded randomised comparative trial","volume":"46","author":"Lin","year":"2021","journal-title":"Reg Anesth Pain Med"},{"key":"R19-20260720","doi-asserted-by":"crossref","first-page":"677","DOI":"10.2147\/JPR.S445000","article-title":"Effect of pericapsular nerve group block with different concentrations and volumes of ropivacaine on functional recovery in total hip arthroplasty: A randomised, observer-masked, controlled trial","volume":"17","author":"Huang","year":"2024","journal-title":"J Pain Res"},{"key":"R20-20260720","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1186\/s12871-022-01787-2","article-title":"The pericapsular nerve group (PENG) block combined with local infiltration analgesia (LIA) compared to placebo and LIA in hip arthroplasty surgery: A multi-center double-blinded randomised-controlled trial","volume":"22","author":"Lin","year":"2022","journal-title":"BMC Anesthesiol"},{"key":"R21-20260720","first-page":"186","article-title":"Anatomic study of innervation of the anterior hip capsule: implication for image-guided intervention","volume":"43","author":"Short","year":"2018","journal-title":"Reg Anesth Pain Med"}],"container-title":["Indian Journal of 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