Ultrasound with nerve stimulation versus ultrasound alone for obturator nerve block in transurethral resection of bladder tumor: A systematic review and meta-analysis

ABSTRACT Background: The obturator nerve block (ONB) is commonly used during transurethral resection of bladder tumor (TURBT) to prevent adductor spasm. Both ultrasound (US)-guided and nerve stimulation (NS) techniques are available, but whether adding NS to US improves block outcomes remains debated.

Methods

We searched PubMed, Cochrane Library, and Web of Science up to 6 April 2026. The rate of adductor spasm prevention, block performance time, onset time, number of needle passes, patient and surgeon satisfaction, and complications were evaluated. Pooled odds ratios (OR) or mean differences (MD) with 95% confidence intervals (CI) were calculated.