Intra-articular hip injections (IAHIs) are commonly used for diagnostic and therapeutic purposes but are often associated with patient anxiety and fear. The disparity between anticipated and experienced pain during IAHIs and the role of pre-injection local anesthesia in pain modulation remains unclear.

To investigate the difference between anticipated and experienced pain during IAHIs and the impact of pre-injection local anesthesia.

This prospective study enrolled 60 patients undergoing IAHI, 30 receiving pre-injection superficial local anesthesia and 30 serving as a control group without pre-injection local anesthesia. Pain levels were assessed using numeric rating scales.

Patients significantly overestimated anticipated pain compared to experienced pain (6.43 ± 2.48 vs 3.68 ± 2.37, P < 0.001). Pre-injection local anesthesia did not significantly reduce experienced pain (3.19 ± 2.38 vs 4.20 ± 2.29, P = 0.130).

Patients overestimate anticipated pain during IAHIs. Pre-injection local anesthesia does not reduce experienced pain.

Invasive prenatal diagnostic procedures, such as chorion villus sampling (CVS) and amniocentesis (AC), are routinely performed to exclude or diagnose fetal chromosomal abnormalities. The aim of this study was to investigate anxiety-dependent pain experience during CVS and AC and the potential factors that increase anxiety and pain levels.

During a 2-year period, women undergoing invasive procedures in three specialist centers were asked to participate in the study. Anxiety was evaluated before the procedure using the Spielberger State-Trait-Anxiety-Inventory, and pain was evaluated directly after the procedure using a verbal rating scale.

Among the women, 348/480 (73%) underwent AC, while 131/480 (27%) underwent CVS. There was a significant correlation between state and trait anxiety (p<0.0001). A positive correlation existed between the degree of anxiety and the level of pain experienced (p=0.01). There was a positive correlation for trait anxiety (p=0.0283) as well as for state anxiety (p=0.0001) and pain perception (p=0.0061) when invasive procedure was performed owing to abnormal ultrasound finding or to a history of fetal aneuploidy. Maternal age was found to be another influencing factor for the experienced pain (p=0.0016). Furthermore, the analysis showed a significant negative correlation between maternal age and anxiety. That applies for trait anxiety (p=0.0001) as well as for state anxiety (p=0.0001). The older the woman, the less anxious the reported feeling was in both groups. The main indication for undergoing CVS was abnormal ultrasound results (45%), and the main reason for undergoing AC was maternal age (58%).

Procedure-related pain intensity is highly dependent on the degree of anxiety before the invasive procedure. In addition, the indication has a significant impact on the emerging anxiety and consequential pain experiences. These influencing factors should therefore be considered during counseling and performance.

Image-guided percutaneous needle biopsy has become the preferred diagnostic modality for bone and soft tissue tumors. However, to the authors' knowledge, the levels of patient anxiety, pain, and satisfaction before and after the procedure have not been studied. Sixty-five patients undergoing image-guided needle biopsy of a possible bone or soft tissue tumor were prospectively surveyed to quantify preprocedure and postprocedure levels of anxiety and pain and to determine demographic and clinical correlates of anxiety, pain, and satisfaction. Anxiety was measured with the Spielberger State-Trait Anxiety Inventory, pain was measured with a visual analog scale, and satisfaction was measured by patient willingness to repeat the procedure if necessary. Statistical analysis was performed with Student's t test, Fisher's exact test, and linear regression analysis. Compared with preprocedure values, trait anxiety (defined as the underlying level of anxiety, P<.0011), state anxiety (defined as the current level of situational anxiety, P<.001), and pain (P<.05) decreased significantly postprocedure. The relationship between changes in pain and state anxiety was significant (r=0.31, P=.014), whereas no relationship was seen between changes in pain and trait anxiety (r=0.13, P=.28). Patients who were somewhat satisfied with the procedure reported higher levels of postprocedure pain than those who were completely satisfied (5.24±2.19 cm vs 1.70±2.08 cm, respectively; P<.001). In other words, lower levels of experienced pain correlated with patient satisfaction. Older age was inversely correlated with postprocedure pain (r=0.41, P=.001), and there was a trend toward increasing dissatisfaction among younger patients.

To explore anxiety and pain felt by women undergoing chorionic villus sampling (CVS) and amniocentesis (AC).

We prospectively questioned 254 women (67 undergoing CVS, 187 AC) before the procedure on their anxiety, after the procedure on their pain felt, and the support they received or desired. The medical team collected technical information concerning each procedure.

The level of anxiety was significantly higher in women undergoing CVS than AC, in those who had received complete information before the procedure, and when indication for the procedure was fetal structural abnormalities. The level of pain was significantly higher in cases of anxious women, those undergoing a CVS rather than AC, those who had undergone invasive prenatal diagnostic procedures in previous pregnancies, in procedures deemed difficult by the operator, and with needle insertion in the lateral part of the uterus. About 30% of women undergoing CVS and 8% of those undergoing AC would have desired some form of pain prevention, mostly with nonpharmacologic therapy.

Prenatal diagnosis is frequently associated with anxiety and pain. We identified factors that could exacerbate either one. When questioned, patients would desire a nonpharmacologic means for pain prevention.

The aim of this study was to evaluate the levels of anticipated and perceived pain and anxiety in expectant mothers at the times of pre-counseling, post-counseling, and post-amniocentesis and to investigate the effect of pre-amniocentesis counseling on the level of pain and anxiety.

This prospective study was carried out on 240 women with singleton pregnancies at mid-trimester. The maternal pain and anxiety levels associated with the procedure were evaluated using the visual analogue scale. Perceived pain and anxiety were assessed before and after counseling the pregnant woman about amniocentesis, and after amniocentesis.

Median anticipated pain levels before (pain 1) and after pre-procedure counseling (pain 2) were 5 and 4, respectively. The actual pain after the procedure (pain 3) was 3. Median levels of anxiety felt by the patients before (anxiety 1) and after pre-procedure counseling (anxiety 2) were 6 and 3, respectively, while the median anxiety after the procedure (anxiety 3) was 5. For the pain and anxiety measurements, the results for each of the comparison times were significantly different from the results for the other two comparison times (P < 0.001).

Adequate pre-amniocentesis counseling effectively reduces the actual level of pain and anxiety felt by the mother undergoing mid-trimester amniocentesis.