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do most of you do the TURBT under GA because of the obturator reflex or are you guys doing spinal + obturator blocks or just spinal?
Hmm. Now I'm confused. We do LMA for 99% of our TURBTs. One old urologist always demands spinal anesthesia to avoid the obturator reflex. One time I did GA and obturator blocks bilaterally, but it took me longer than I wanted, and then it turned out to be a ditzel TURBT, so I have no idea if it worked. I suppose you'd have to use sux to really abolish the reflex under GA.
I've never personally seen nor heard of this mythical obturator reflex, even with significant lateral wall disease in some of these patients... other than reading about it in case reports.
I have seen it before and it's pretty impressive.