Pudendal neuralgia (PN) is a painful and disabling condition, which reduces the quality of life as well. Pudendal nerve infiltrations are essential for the diagnosis and the management of PN. The purpose of this study was to compare the effectiveness of finger-guided transvaginal pudendal nerve infiltration (TV-PNI) technique and the ultrasound-guided transgluteal pudendal nerve infiltration (TG-PNI) technique. Forty patients who underwent PNI for the diagnosis of PN were evaluated. Thirty-five of these 40 patients, who were diagnosed as PN, underwent a total of 70 further unilateral PNI. All the patients underwent PNI for twice after the first diagnostic PNI, 1 week apart. In the ultrasound (US)-guided TG-PNI group, the success rate was 68.8% (11 of 16) in both "pain in the sitting position" and "pain in the region from the anus to the clitoris." The success rate of blocks in the US-guided TG-PNI group was 75% (12 of 16) in terms of pain during/after intercourse. In the finger-guided TV-PNI group, the success rate was 84.2% in both "pain in the sitting position" and "pain in the region from the anus to the clitoris." The success rate of blocks in the fingerguided TV-PNI group was 89.5% (17 of 19) in terms of pain during/after intercourse. There was no statistically significant difference in the success rate of the 3 assessed conditions between the 2 groups (P>0.05). The TV-PNI may be an alternative to US-guidance technique as a safe, simple, effective approach in pudendal nerve blocks.

We aimed to evaluate the effectiveness of ultrasound-guided facia iliaca compartment (FIC) and erector spinae plane (ESP) blocks in managing postoperative pain following total hip arthroplasty surgery. A total of 60 patients were randomized into two groups (n = 30): FIC and ESP blocks were performed with 30 mL 0.25% bupivacaine at the end of the surgery. The patients received intravenous tramadol and patient-controlled postoperative analgesia. The pain scores, opioid consumption, and adverse events were recorded. The dynamic pain scores on movement in the postoperative 1^st hour were significantly lower in the ESP block group than in the FIC block group [3(2–4) vs. 4(2–5), respectively; p = 0.035]. Postoperative opioid consumption within the first postoperative 8 hours was significantly higher in the FIC block group than the ESP block group [80 mg (61–100) vs. 100 mg (80–120), respectively; p = 0.010]. The adverse effects of opioids did not differ between the two groups. ESP and infrainguinal FIC blocks provided similar postoperative analgesia 24 hours after total hip arthroplasty. The ESP block is more beneficial than the FIC block in terms of pain scores and opioid consumption in the early hours of the postoperative period.

Background The aim of this study is to investigate the factors affecting symptoms of anxiety and depression in the family members of critically ill patients. Methods This prospective cohort study was conducted in an adult tertiary care mixed medical–surgical intensive care unit (ICU) at a tertiary-level teaching hospital. The symptoms of anxiety and depression of first-degree adult relatives were evaluated with the Hospital Anxiety and Depression Scale. Four family members were interviewed and asked about their experiences during the ICU process. Results A total of 84 patients and their family members were included in the study. The symptoms of anxiety were present in 44/84 (52.4%), and depression was present in 57/84 (67.9%) family members. A nasogastric tube was found to be related to anxiety (p = 0.005) and depressive symptoms (p = 0.002). The family members of the patients with an acute developed illness had 3.9 (95% confidence interval [CI]: 1.4–10.9) times the odds of having the symptoms of anxiety and 6.2 (95% CI: 1.7–21.7) times the odds of having the symptoms of depression than the family members of the patients with an illness developed on a chronic basis. The family members of the patients who died in the ICU had 5.0 (95% CI: 1.0–24.5) times the odds of being depressed than the patients discharged from the ICU. All interviewees stated having difficulty understanding and remembering what was told. The common feelings of all the interviewees were desperation and fear. Conclusions Awareness of the emotional stress of family members can help develop interventions and attitudes to alleviate symptom burden.