This study investigated the association between fear of childbirth (FOC) and women's knowledge about painless childbirth methods. The study was performed on 900 multiparous women within the last month of pregnancy. Data was obtained through a questionnaire including the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) Turkish form A. FOC was defined as W-DEQ sum score ≥85. Women were questioned about their knowledge about painless childbirth and the most important source of this knowledge. Group 1 consists of participants with knowledge about painless childbirth. Group 2 consists of participants without knowledge about painless childbirth. Five hundred and twenty-four women (58.2%) had knowledge while 376 women (41.7%) had no knowledge about painless childbirth. Mean W-DEQ scores in group 1 (68.46 ± 12.53) were found to be lower than group 2 (71.35 ± 12.28) (P = 0.001). FOC was associated with increased maternal request for elective caesarean section (OR 4.22, 95% CI 2.91–6.11). Better informed pregnant women about painless childbirth methods may reduce the number of women with FOC and the rate of preferred elective caesarean section.

The study was registered with a clinical trials registry (ClinicalTrials.gov. identifier NCT02725359).

BackgroundOur aim is to compare the hemodynamic effects of combined psoas compartment-sciatic nerve block (PCSNB) with continuous spinal anaesthesia (CSA) in elderly high-risk patients undergoing hip replacement surgery.MethodsSeventy patients over the age of 60 with ASA III or IV physical status were randomly allocated to two groups: In the PCSNB group, ultrasound-guided psoas compartment block was performed with modified Winnie technique using 30 mL of 0.25% bupivacaine with 1:200.000 epinephrine (5 μgr/mL) and iliac crest block was performed using the same local anaesthetic solution (5 mL). All patients in the PCSNB group needed continuing infusion of propofol (2 mg/kg/h) during operation. In the CSA group, CSA was performed in the L3-L4 interspaced with the patient in lateral decubitus position using 2.5 mg of isobaric bupivacaine 0.5%. When sensory block was not reached to the level of T12 within 10 minutes in the CSA group, additional 2.5 mg of isobaric bupivacaine 0.5% was administered through the catheter at 5-min intervals by limiting the total dose of 15 mg until a T12 level of the sensory block was achieved.ResultsThe PCSNB group had significantly higher mean arterial blood pressure values at the beginning of surgery and at 5th, 10th and 20th minutes of surgery compared to the CSA group (P =0.038, P =0.029, P =0.012, P =0.009 respectively). There were no significant differences between groups in terms of heart rate and peripheral oxygen saturation values during surgery and the postoperative period (P >0.05). Arterial hypotension required ephedrine was observed in 13 patients in the CSA and 4 patients in the PCSNB group (P =0.012).ConclusionsCSA and PCSNB produce satisfactory quality of anaesthesia in elderly high-risk patients with fewer hemodynamic changes in PCSNB cases compared with CSA cases.Trial registrationAustralian New Zealand Clinical Trials Registry: ACTRN12614000658617, Registered 24 June 2014.

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Objective: The purpose of this study was to investigate the effect of the modified thoracolumbar interfascial plane block (TLIP) on postoperative analgesia and quality of recovery in patients undergoing lumbar disk surgery. Method: Ninety patients scheduled for lumbar disk surgery were divided into a control group (Group C) and a modified TLIP block group (Group T). Controlled analgesia was administered to both groups. Pain evaluation was performed at 30 min and at 1., 2., 4., 8.,12., and 24. hrs using a VAS scale, with patients at rest and duringand patients completed the QoR-40 quality of recovery inventory. Results: Fentanyl used during postoperative 24 hours was 742.5±220.3 mcg in Group C and 446.0±241.98 in Group T. Postoperative fentanyl consumption was statistically significantly lower in Group T (p<0.001) with a statistically significant intergroup difference. The patient's pain, physical independence, physical comfort, psychological support, and emotional support were compared using the QoR-40 questionnaire survey. Significant differences in favor of Group T were observed (p<0.001, p=0.017, p=0.002, p=0.001 and p<0.001, respectively). Static and dynamic pain scores in Group C and Group T were recorded at 30 min and at 1, 2, 4, 8, 12, and 24 h. Mean static scores were statistically significantly different in favor of Group T with the exception of 8 th and 12 h assessments (p<0.05). Dynamic scores were statistically significantly different in favor of Group T at all time points (p<0.05). Conclusion: Pain scores, opioid consumption and QoR-40 values after lumbar disk surgery were superior in the group undergoing TLIP. We think that the modified TLIP block may be an important method in terms of postoperative analgesia and patient recovery for lumbar spinal disk surgery.

Our results show that metamizole is more effective than paracetamol for treating surgical trauma-related pain, inflammation, and oxidative stress and hence may be a preferential drug to paracetamol.

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