A STUDY TO COMPARE THE EFFICACY OF SUBARACHNOID BLOCK VERSUS SADDLE BLOCK COMBINED WITH ULTRASOUND GUIDED OBTURATOR NERVE BLOCK FOR TRANSURETHRAL RESECTION OF PROSTATE: A RANDOMIZED CONTROLLED TRIAL

Background Regional anaesthesia is often chosen over general anaesthesia for transurethral resection of prostate (TURP) due to better safety profile. Subarachnoid block (SAB) a long-standing technique it may cause hypotension and bradycardia which is concerning in elderly. Saddle block by acting on sacral nerve roots gives sufficient anaesthesia to perineal region while maintaining stable hemodynamics. Combining it with ultrasound-guided obturator nerve block (ONB) helps reduce thigh adduction during resection, thus lowering risk of bladder injury and improving surgical ease. This study aimed to assess the difference between SAB and saddle block plus ONB in terms of blood pressure stability, motor block and satisfaction of the surgeon. Methods Eighty male patients aged 50 to 75 years with ASA I to III posted for elective TURP were randomly assigned into two equal groups( CTRI/2024/04/065037). Group A received SAB, while Group B got saddle block plus USG-guided ONB with 12 ml of 0.5% bupivacaine. Mean arterial pressure, heart rate, systolic BP, time to reach T10 sensory level, motor block grading, surgeon satisfaction and any intraoperative issues were recorded. Results Group B had more stable vitals. Motor block was deeper in Group A. Time to achieve T10 was slightly delayed in Group B. Surgeon satisfaction was better in Group B. Complications like hypotension and bradycardia occurred more in Group A. Conclusion Saddle block with obturator block may be a safer and effective approach in elderly undergoing TURP, offering better stability and faster recovery.