Comparison of proximal versus distal approach for ultrasound guided obturator nerve block for prevention of adductor spasm in patients undergoing transurethral resection of bladder tumour

Patient assessed for eligibility, Preoperative assessement and prepration will be done, Written informed consent from patient/ guardian will be taken Patient will be shifted to operation theatre and monitors attached. Baseline vitals will be noted. Intravenous line established and i.v injection fentanyl 0.5 mcg/kg will be given to each patient. Randomisation into two groups- proximal group (P group) or distal (D group) will be done Ultrasound guided obturator nerve block will be performed by proximal or distal approach . Block performance time ,number of needle passes, complications will be noted. Patient will be monitored.Adductor muscle power will be assessed and graded after 15 minutes. spinal anesthesia will be given with 2.5 ml of 0.5% bupivacaine with 10 mcg fentanyl. After confirming the sensory blockade at T-10 level surgery will be started Success rate will be determined by the absence of adductor jerk/ spasm during the surgery. If any jerks are observed and leads to discontinuation of surgery , it will be noted and general anaesthesia will be given. Surgeon satisfaction will be noted at end of surgery