SIMULTANEOUS BILATERAL OBTURATOR NERVE-STIMULATION DURING TRANSURETHRAL ELECTROVAPORIZATION OF THE PROSTATE

Transurethral vaporization of the prostate is ct new method of electro surgery used for treating benign prostatic hypertrophy. We observed si multaneous obturator nerve stimulation during spinal anesthesia while the middle lobe of the prostate was being resected. A discussion of wh y electrovaporization is different from traditional electrocautery dev ices is presented. Due to the increased power required during electrov aporization, and the arcing at the electrode, a large amount of demodu lated, low-frequency: current is produced that can stimulate the obtur ator nerve. This can occur even if the electrode is not close to the l ateral bladder wall. The solution to the problem of obturator nerve st imulation, including bilateral obturator nerve blocks using a lower po wer setting during resection and converting from a regional to general anesthetic with neuromuscular blockade, is discussed. (C) 1998 by Els evier Science Inc.