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

VISKON-RS : Rapid Damage Assessment Software with Remote Sensing

23nd Signal Processing and Communications Applications Conference (SIU) -- MAY 16-19, 2015 -- Inonu Univ, Malatya, TURKEYWOS: 000380500900422After a disaster, a rapid damage assessment is required for coordinating emergency response teams and planning emergency aid. In this study, in line with AFAD requirements, ViSKON-RS software was developed for the aim of using disaster damage assessment by analysing images obtained via remote(space/air) imaging technologies. The developed software includes specialized applications for damage assessment of disaster types such as earthquake, flood and forest fires. In addition, applications for general image analysis were integrated to the software like change detection analysis, supervised/unsupervised classification, object based image analysis and texture analysis. The main purpose of ViSKON-RS software is to be integrated software solution by opening, processing, analysing, showing and exporting results to desicion support system of post-disaster remote sensing data.Dept Comp Engn & Elect & Elect Engn, Elect & Elect Engn, Bilkent Uni