Background: This study aimed to compare paravertebral block and continuous intercostal nerve block after thoracotomy. Methods: Forty-six adult patients undergoing elective posterolateral thoracotomy were randomised to receive either a continuous intercostal nerve blockade or a paravertebral block. Opioid consumption and postoperative pain were assessed for 48 hours .Pulmonary function was assessed by forced expiratory volume in 1 s (FEV1) recorded at 4 hours intervals. Results: With respect to the objective visual assessment (VAS), both techniques were effective for post thoracotomy pain. The average VAS score at rest was 29±10mm for paravertebral block and 31.5±11mm for continuous intercostal nerve block. The average VAS score on coughing was 36±14mm for the first one and 4 ±14mm for the second group. Pain at rest was similar in both groups. Pain scores on coughing were lower in paravertebral block group at 42 and 48 hours. Post-thoracotomy function was better preserved with paravertebral block. No difference was found among the two groups for side effects related to technique, major morbidity or duration of hospitalisation. Conclusion: We found that continuous intercostal nerve block and paravertebral block were effective and safe methods for post-thoracotomy pain.
Background: Taste disorders (TDs) have been reported to be very common in patients suffering from coronavirus disease 2019 (COVID-19), which is caused by the SARS-CoV-2 virus. In most of the hitherto conducted studies, a gustatory assessment was performed on the basis of surveys or self-reports by patients. The aim of our study was to undertake an objective assessment of four basic taste qualities by conducting tasting sessions that allowed detection thresholds in COVID-19 Tunisian patients and to study their associations with inflammation. Methods: This analytical cross-sectional study was conducted on 89 patients aged between 21 to 70 years who had been diagnosed with COVID-19. We used Burghart taste strips to assess taste perception of the four taste qualities, i.e., sour, bitter, sweet, and salty. Serum levels of interleukin-1β (IL-1β), interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), and C-reactive protein (CRP) were measured. Results: Taste disorders were reported by 40.4% of the patients, while objective assessments revealed that 63.8% of participants were suffering from hypogeusia and/or ageusia. Sour taste was the most altered (70.8%) gustatory quality. Patients with severe COVID-19 had significantly lower sour and bitter taste scores when compared to patients with minor/moderate forms. There was no significant association between serum inflammatory markers and taste disorders. However, the relationship between bitter and sweet taste qualities and IL-1β levels was significant (p = 0.018 and p = 0.041). Conclusions: Our results demonstrate the interest in the objective assessment of taste dysfunctions in COVID-19 patients.
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