Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

The Effect of Streptomycin on Freezing Rainbow Trout (Oncorhynchus mykiss) Sperm

Mature male and female rainbow trout (Oncorhynchus mykiss) were used to study the effect of different concentrations of streptomycin in a cryopreservation solution on the sperm motility, motility duration, and fertilization rate of rainbow trout. 300mM glucose and 10% DMSO containing diluent was used as a cryopreservation solution. Three different concentrations (3600, 7200 and 10800 μg/ml) of streptomycin were added to the diluent. Our study showed that various concentrations of streptomycin in cryopreservation solution caused a significant reduction in the percentage and duration of rainbow trout spermatozoa motility after freezing-thawing. The percentage of egg fertilization also decreased. When streptomycin-containing groups were compared with each other, a statistical difference was found (p<0.05). However, no statistical difference was observed in terms of the percentage of eyed-embryos

Effects of different dietary lipid resources on sperm quality and reproductive success in rainbow trout (Oncorhynchus mykiss)

© 2021 John Wiley & Sons LtdThe present study evaluated the effects of dietary fish oil replacement with linseed or sesame oil on sperm quality and reproductive performance in rainbow trout (Oncorhynchus mykiss) during a 7-month feeding trial. Male (≈ 970 g) broodfish were fed three isonitrogeneous and isolipidic formulated diets containing fish oil (FO diet), linseed oil (LO diet) and sesame oil (SO diet). Commercial trout broodfish diet was fed to another group to serve as control (CD). Growth performance was not affected by diet. Slight variations in volume, pH and density were recorded in the semen produced by rainbow trout subjected to the different dietary treatments (p > 0.05). Similarly, motility and kinematic parameters were not influenced by diets (p > 0.05). However, osmolality differed in the dietary groups, with semen from SO and LO fed fish having comparatively higher values (p < 0.05). Fatty acid (FA) profile of fish spermatozoa reflected dietary FA composition. FA profile of spermatozoa showed evidence of de novo biosynthesis of eicosapentaenoic acid, docosahexaenoic acid and arachidonic acid. Dietary treatments did not significantly affect reproductive performance (fertilization, eyeing and hatching rates). This may be suggestive of the ability of male rainbow trout to synthesize HUFA in vivo to meet their reproductive needs in the event of low dietary n-3 HUFA supplementation

Effects of Different Doses of Taurine in the Glucose-Based Extender During Cryopreservation of Rainbow Trout ( Oncorhynchus Mykiss

This study aimed to investigate the effects of different doses of taurine added to glucose extender Semen was collected from rainbow trout (Oncorhynchus mykiss) by abdominal massage and diluted (1:2) with 300 mM glucose (G) extender containing different taurine doses (50, 75 and 100 mM). The control group extender did not contain taurine. After dilution and dosing, samples were filled to 0.5 ml straws, frozen in nitrogen vapour and stored in liquid nitrogen. The comparison of the results obtained for the 50 mM taurine group and the control group showed no significant difference between the post-thawing motility percentages and motility duration of sperm, and only a very low statistically difference for eyed-embryo percentages (P < 0.05)