68 research outputs found
Ratlarda oral veya topikal olarak uygulanan borun yara iyileşmesi ve oksidatif stres üzerine etkilerinin karşılaştırılması
The purpose of this study was to determine the effects of boron on wound healing and further evaluate some
antioxidant and oxidant characteristics. A total of 32 adult male Wistar rats were divided into four groups; control
group, local boron (LB) group, oral boron (OB) group, and oral+local boron (OLB) group. Under general
anesthesia, a circular full-thickness skin defect with a diameter of 1.5 cm was created on the dorsal region of the
rats. Boron (10 mg/kg) was administered per oral in OB group and 3% boric acid was administered topically in
LB group, and 10 mg/kg boron was administered per oral and 3% boric acid was applied topically in OLB group.
Control group did not receive any medication. In histopathological examination, re-epithelialization, granulation
tissue formation, collagen formation, inflammatory cell formation, and neovascularization were found to be more
superior in LB and OLB groups as compared to the control and OB groups. Blood and wound tissue MDA levels
in OB and OLB groups were lower with respect to the control and LB groups (p<0.05). In conclusion, oral
administration of boron in addition to topical treatment contributes the wound healing due to the antioxidant
property of boron in wound healing process.Bu çalışmanın amacı, borun yara iyileşmesi ve bazı antioksidan ve oksidan parametreler üzerine olan etkisinin
belirlenmesidir. Çalışmada, toplam 32 adet erişkin erkek Wistar ratı, kontrol grubu, lokal bor (LB) grubu, oral bor
(OB) grubu ve oral+lokal bor (OLB) grubu olmak üzere ratgele dört gruba ayrıldı. Genel anestezi altında,
ratların sırt bölgesinde 1,5 cm çapında dairesel tam kat bir deri defekti oluşturuldu. OB grubunda bulunan ratlara
oral olarak 10 mg/kg bor, LB grubunda bulunan ratlara topikal % 3’lük borik asit, OLB grubunda bulunan ratlara
oral 10 mg/kg bor ile birlikte topikal olarak % 3’lük borik asit uygulandı. Kontrol grubuna ise herhangi bir ilaç
uygulanmadı. Histopatalojik inceleme için yara dokusu örnekleri alındı. Histopatolojik olarak; repitelizasyon,
granulasyon dokusu oluşumu, kollagen formasyonu, yangısal hücre oluşumu ve neovaskülarizasyonun LB ve OLB
gruplarında kontrol ve OB grubuna göre daha iyi olduğu belirlendi. OB ve OLB gruplarında kan ve yara dokusu
MDA düzeylerinin kontrol ve LB grubuna göre düşük olduğu belirlendi (p<0,05). Sonuç olarak; yara sağaltımında,
lokal olarak borik asit kullanıma ek olarak antioksidan özelliklerinden dolayı oral bor kullanımının yara
iyileşmesine katkı sağladığı söylenebilir
Public Attitude to Nuclear Energy from Climate Change and Energy Security Perspectives in Turkey
Abstract. Most of the energy-environmental policy studies have argued nuclear energy since the second half of the 20th century as it includes a number of risk factors such as high cost of plant building, radiation, diseases, power plant accidents, nuclear waste, nuclear weapon proliferation and terrorism. The length and severity of the nuclear energy debates vary from country to country based on the several factors, in particular, the economic and social development level of the countries. Due to increasing global environmental concerns such as climate change, loss of biodiversity, natural research depletion, deforestation, ozone layer depletion and recent problems that countries experienced in terms of energy security, especially for such developing countries as Turkey, the governments have relaunched nuclear energy program again and follow their energy policy agenda in spite of occasional anti-nuclear protests in the society. In this regard, the main purpose of this study is to evaluate the public attitude in Turkey to nuclear energy in terms of environmental values like climate change and energy security and at the same time to examine reconciliation of environmental values and energy security with public attitude to nuclear energy. In the literature, many studies concerning environmental values, energy security, and attitudes towards nuclear energy have been conducted for only industrialized countries such as the USA, England, and Japan. However, developing countries with a high energy demand, technical and financial difficulties for low-carbon and renewable energy technology have been neglected, which is the source of inspiration and motivation for this study. The main finding of the study is that environmental values, especially, climate change plays a more important role in public attitude to nuclear energy in the community than energy security, which might be evaluated as an essential input for relevant stakeholders on energy policy in Turkey.Keywords. Nuclear energy, Public attitude, Climate change, Energy security.JEL. O13, Q42, Q54
Bir kedide ısırık yarası kaynaklı rektokutanöz fistül tedavisi
Recto-cutaneous fistulas, which are common in humans, rarely occur in companion animals. In this case report, we aimed to provide information to our colleagues about the diagnosis and treatment of recto-cutaneous fistula in a cat. A one and a half months old British shorthair kitten, weighing 600 g, was brought to Afyon Kocatepe University Veterinary Health Application and Research Center Surgery Clinic by its owner because of an open wound on the side of the tail for a week, and feces coming from this wound. Recto-cutaneous fistula was diagnosed on clinical examination. Under general anesthesia, the defect was sutured with simple pattern. Since the skin sutures were opened, the wound was treated with rifamiycine, nitrofurazone ointment and bephanthene cream after irrigation with rivanol %0.1. In conclusion, recto-cutaneous fistula, which is the most important complication of rectal perforation for any reason, is rarely seen in cats and dogs. Accurate diagnosis and treatment are important for rapid recovery.İnsanlarda sıklıkla görülen rektokutanöz fistüller, evcil hayvanlarda nadiren ortaya çıkar. Bu olgu sunumunda, yavru bir kedide karşılaşın rektokutanöz fistül olgusunun tanı ve tedavisi hakkında klinisyen meslektaşlarımıza bilgi vermek amaçlanmıştır. Biritish shorthair ırkı 1,5 aylık 600 gr ağrılığındaki bir kedi, kuyruğunun yanında içinden dışkı gelen bir yara şikayetiyle Afyon Kocatepe Üniversitesi Veteriner Sağlık Uygulama ve Araştırma Merkezine getirildi. Klinik muayene yapılarak rektokunatöz fistül tanısı konuldu. Genel anestezi altında rektumdaki defekt belirlendi ve basit ayrı dikiş uygulaması yapılarak kapatıldı. Deri dikişleri açıldığı için %0,1’lik rivanol ile irrigasyon sağlandıktan sonra rifamisin ampul, furasin pomad ve bepanten krem ile yara tedavisi yapıldı. Sonuç olarak, herhangi bir sebeple oluşan rektum perforasyonunun en önemli komplikasyonu olan rektokutanöz fistül kedi ve köpeklerde nadiren görülen bir durumdur. Doğru teşhis ve tedavi iyileşmenin hızlı şekillenmesinde önemlidir
Evaluation of some trace element levels in serum and claw tissue in cattle with different claw lesion
Bu çalışmanın amacı; sağlıklı ve çeşitli tırnak lezyonu bulunan sığırlarda serum ve tırnak dokusu krom (Cr), manganez (Mn), demir (Fe), kobalt (Co), bakır (Cu), çinko (Zn) ve selenyum (Se) düzeylerinin karşılaştırılması ve tırnak lezyonu ile iz element düzeyleri arasındaki ilişkinin değerlendirilmesidir. Çalışmada 10 sağlıklı sığır ve 30 tırnak lezyonu bulunan sığır olmak üzere toplam 40 sığır kullanıldı. Sağlıklı ve tırnak lezyonu bulunan sığırların tırnak uzunluk ölçüleri ve tırnak sertlik değerleri belirlendi. Her iki grupta serum ve tırnak dokusu iz element düzeylerinin belirlenebilmesi için kan ve tırnak dokusu (tırnak tabanı ve duvarı) örnekleri alındı. Serum ve tırnak dokusu örneklerinde; Cr, Mn, Fe, Co, Cu, Zn ve Se seviyeleri analiz edildi. Lezyonlu tırnağa sahip sığırların tırnak tabanı sertlik değerinin sağlıklı sığırlara göre daha yüksek olduğu belirlendi. Lezyonlu tırnağa sahip sığırların paries ungulae Cr, Mn, Fe, Co ve Se düzeylerinin sağlıklı sığırlara göre yüksek olduğu, sağlıklı sığırların ise paries ungulae Cu düzeyinin tırnak lezyonu bulunan sığırlara göre istatistiksel olarak anlamlı düzeyde daha yüksek olduğu saptandı. Sağlıklı sığırların; tırnak dokusu solea ungulae, Cr, Zn ve Cu düzeylerinin tırnak lezyonu bulunan sığırlara göre daha yüksek; Mn, Fe, Co ve Se düzeylerinin ise tırnak lezyonu bulunan sığırlara göre daha düşük olduğu gözlendi. Sonuç olarak, tırnak lezyonu bulunan sığırlarda tırnak tabanı Cu ve Zn düzeyinin, sağlıklı sığırlara göre daha düşük olduğu gözlendi. Tırnak sağlığı açısından Mn, Zn, Cu ve Se gibi iz elementlerin oldukça önemli olduğu, tırnak tabanı Cu ve Zn seviyesi düşük olan sığırlarda tırnak lezyonu oranının arttığı söylenebilir.The aim of this study was to compare levels of serum and claw tissue chromium (Cr), manganese (Mn), iron (Fe), cobalt (Co), copper (Cu), zinc (Zn) and selenium (Se) in healthy cattle with various claw lesions and to evaluate the relationship between claw lesion and trace element levels. A total of 40 cattle were used as 10 healthy cattle and 30 cattle with claw lesions in the study. Hoof conformation measurements and hoof hardness values were determined in both healthy cattle and cattle with claw lesions. Blood and claw tissue samples (hoof wall and solar hoof) were taken to determine serum and claw tissue trace element levels in both groups. Cr, Mn, Fe, Co, Cu, Zn and Se levels were analysed in serum and claw tissue samples. It was determined that the hardness value of the solar in the cattle with hoof lesions was higher than the healthy cattle. Cr, Mn, Fe, Co and Se levels in paries ungulae were found to be higher in the cattle with claw lesions, compared to the healthy cattle, while the Cu level of paries ungulae was statistically significantly higher in the healthy cattle compared to the cattle with claw lesions. In healthy cattle;, Cr, Zn and Cu levels in sola ungulae hoof tissue were higher than the cattle with claw lesions, while the Mn, Fe, Co and Se concentrations were lower than in those cattle with claw lesions. As a result, it was observed that Cu and Zn levels of the solear hoof in cattle with claw lesions were lower than in the healthy cattle. It can be suggested that trace elements such as Mn, Zn, Cu ve Se are very important for hoof health, and low levels of Cu and Zn in the solar hoof can increases rate of claw lesions in cattle with claw lesions
Evaluation of Intraperitoneal and Incisional Bupivacaine or Levobupivacaine for Postoperative Analgesia in Ovariohysterectomized Dogs
Background: Ovariohysterectomy (OHE) is the most commonly performed elective surgical procedure in companion animals. OHE offers benefits of control of population and decreased risk of potentially life-threatening diseases such as mammarian tumours and pyometra. Traditional OHE intervention causes inflammation and pain due to trauma during organ manipulation. The purpose of this study was to compare the effect of intraperitoneal and incisional administration of bupivacaine (BP) or levobupivacaine (LP) on postoperative analgesia in dogs undergoing the OHE procedure.Materials, Methods & Results: A total of 24 mix-breed bitches aged between 1 - 3 years and weighed 19 - 20 kg were used in this study. The animals were divided into three groups as control (n = 8), BP (n = 8) and LP group (n = 8). The animals were kept under surveillance at the hospitalisation unit of the animal hospital for one day before the elective OHE. The dogs were fasted for 12 h before the surgery, with adlib water consumption. Atropine sulphate 0.045 mg/kg was administered subcutaneously approximately 30 min before general anaesthesia. Midazolam (0.3 mg/kg) was intravenously injected into all dogs for pre-anaesthetic medication. After sedation, anaesthesia was induced with propofol (4 mg/kg, IV) and then the dogs were orotracheally intubated using cuffed endotracheal tubes. General anaesthesia was maintained by administration of 2% isoflurane. The ventral abdomen was prepared aseptically for OHE following the general anaesthesia. All animals were operated on by the same surgeon. During surgery, sprayed bupivacaine 0.5% (4.4 mg/kg) with an equal volume of saline in BP group, levobupivacaine 0.5% (4.4 mg/kg) with an equal volume of saline in LP were then applied over the ovaries, uterine broad ligaments and cervix uteri. After removal of the uterine body, either LP or BP was sprayed to left and right, or cranial and caudal parts of the abdominal cavity. Finally, the incision line was sprayed before closing the skin. The control group received only sprayed saline. The pain evaluation was carried out with modified Melbourne pain scoring scale. To determine cortisol concentrations, blood samples were taken before anaesthesia induction (baseline) and postoperative 0, 0.5, 1, 2, 4, 6, 12 and 24 h. Postoperative pain scores were higher in the control group than BP and LP groups following surgery at 30 min, 1st, 4th, and 6th h. In all groups, cortisol levels increased postoperatively, whereas they decreased more rapidly in BP and LP groups. There was a steady increase at postoperative 0 min, 30 min, 1st, 2nd, 4th and 6th h in the control group and at postoperative 0 min, 30 min and 1 h in BP and LP groups (P < 0.05).Discussion: Intraperitoneal and incisional bupivacaine shows significantly superior postoperative pain management benefits after the closure of skin, compared to untreated dogs and it is also superior to lidocaine treatment at 0.5 h following the visual analogy pain assessment system. In the present study, the observation of lower pain scores in BP group at 0.5, 1, 4 and 6 h as compared to the control group was similar to findings of other studies. LP group also showed decreased pain scores at above-mentioned h without any significant difference. However, only in LP group, pain scores at 24 h were lower than postoperative pain scores. In conclusion, it is suggested that sprayed intraperitoneal and incisional BP and LP are very effective for preventing postoperative pain ovariohysterectomized dogs
Trichofolliculoma in a guinea pig: Diagnosis and surgical treatment
Bu çalışmada, bir Gine domuzunda gözlenen trikofolliküloma olgusu ve cerrahi sağaltımı tanımlanmaktadır. Üç yaşında, dişi ve 800 gr ağırlığında bir ginepig sol lumbo-sakral bölgede şişkinlik şikâyeti ile Afyon Kocatepe Üniversitesi, Veteriner Fakültesi, Hayvan Hastanesine getirildi. Klinik muayenede şişkinliğin katı-esnek kıvamda ve enfekte olduğu görüldü. Enfeksiyon kontrol altına alındıktan sonra kitlenin cerrahi olarak uzaklaştırılmasına karar verildi. Kitle cerrahi olarak uzaklaştırıldı ve uzaklaştırılan doku histopatolojik inceleme için laboratuvara gönderildi. Kitlenin 8 gr ağırlığında 3,5x3x0,6 cm boyutlarında olduğu tespit edildi. Histopatolojik inceleme sonucunda uzaklaştırılan kitlenin trikofolliküloma olduğu tespit edildi. Hayvanın postoperatif on gün sonra yapılan kontrollerinde tamamen iyileştiği gözlendi ve dikişler uzaklaştırıldı. Sonuç olarak, bir gine domuzunda cerrahi girişimle başarılı bir şekilde sağaltılan trikofolliküloma olgusunun klinisyen veteriner hekimlerin dikkatine sunulmasının yararlı olacağı kanısına varılmıştır.This study was designed to describe the case of trichofolliculoma and its surgical treatment in a Guinea Pig. A 3-year-old male Guinea Pig, weighing 800 gr was referred to the Afyon Kocatepe University, Animal Hospital with complaint of swelling on lumbo-sacral area. The clinical examination revealed that the mass was solid-elastic consistency and infected. It was decided to remove the mass by surgical intervention following the treatment of infection. The mass was removed surgically and the removed tissue was transfered to laboratory for histopathologic examination. It was observed that the mass was 3 gr and 3.5x3x0.6 cm in size. Trichofolliculoma was diagnosed by histopathologically. The sutures were removed ten days later. Postoperative examination showed that the animal was completely recovered In conclusion, it was suggested that the description of diagnosis and successful surgical treatment of trichofolliculoma in a guinea pig may be helpful for veterinary practitioner
Ratlarda renal iskemi/reperfüzyon hasarında curcumin'in etkileri
Bu araştırmada, Renal İskemi/Reperfüzyon Hasarı Modelinde Curcumin'in etkilerini biyokimyasal ve histopatolojik olarak araştırmak amaçlanmıştır. Çalışmada ratlar kontrol (C), sham, iskemi repürfüzyon (I/R) ve curcumin (CUR) grubu olmak üzere (n=6) toplam 24 dişi Wistar Rat kullanılmıştır. Genel anestezi altında Grup I/R ve CUR da laparatomi uygulanarak sol böbrek pedikülü diseke edilmiş ve böbrek arteri klempe edilerek 1 saat iskemi ve 6 saat reperfüzyon gerçekleştirilmiştir. Grup CUR da 500 mg/kg Curcumin iskemi sonrası intraperitonal olarak verilmiştir. Serum MPO, IMA, MDA, NO, SOD, GPx, AOS , üre ve kreatinin ölçümleri gerçekleştirilmiştir. Doku örneklerinde MPO, MDA, NO, SOD, GPx, AOS ölçülmüştür. Histopatolojik inceleme ile böbrek dokusunda I/R hasarı skorlanmıştır. Serum ve doku AOS Grup I/R Grup CUR ile karşılaştırıldığında istatistiksel önemi olacak şekilde Grup CUR'de yüksel bulunmuştur (p<0.05). Doku NO düzeyi I/R grubu ile karşılaştırıldığında Grup CUR’da istatistiksel önemi olacak şekilde düşük bulunmuştur (15,30±5,41, 4,8±1,37) (p<0.05). Histopatolojik skorlamada Grup CUR, Grup I/R ile karşılaştırıldığında istatistiksel olarak anlamlı olacak şekilde düşük bulunmuştur (p<0.05). Sonuç olarak; bu araştırmada Curcumin’in Renal I/R hasarı modelinde serum ve doku örneklerinde oksidatif stresi azaltarak I/R hasarını önlemede olumlu etkisi olduğu ve histopatolojik inceleme ile de Curcumin'in bu olumlu etkisi desteklenmiştir.This study aimed to investigate the biochemical and histopathological effects of curcumin on Renal Ischemia/Reperfusion Injury. Twenty-four female Wistar rats were used in the study and divided into control (C), sham, ischemia/reperfusion (I/R), and curcimin (CUR) groups (n=6). Laparotomy was performed under general anesthesia in I/R and CUR groups than the left renal pedicle was dissected it was clamped. Then, 1-h ischemia and 6-h reperfusion were applied. 500 mg/kg Curcumin was given intraperitoneally to the CUR group after ischemia application. MPO, IMA, MDA, NO, SOD, GPx, AOS, urea, and creatinine levels were measured in serum samples. MPO, MDA, NO, SOD, GPx, and AOS were also measured in tissue samples. The histopathological examination was performed. Serum and tissue AOS levels were significantly higher in the CUR group than in the I/R group (P<0.05). Tissue NO levels were significantly lower in the CUR group than in the I/R group (15.30±5.41 and 4.8±1.37, respectively) (P<0.05). Histopathological scores were also significantly lower in the CUR group than in the I/R group (P<0.05). The results showed that curcumin prevented I/R damage by decreasing oxidative stress in serum and tissue samples in rat renal I/R model
Bir boxer ırkı köpekte torakal spondilozis deformans olgusu
Bu olgu sunumunun materyalini 5 yaşlı, boxer ırkı erkek köpek oluşturdu. Alınan anamnez bilgide olgunun yürürken ve merdiven inip çıkarken isteksiz olduğu ve ağrı duyduğu, ön ekstremitelerde koordinasyon bozukluğu olduğu, sallantılı şekilde yürüdüğü öğrenildi. Yapılan klinik ve ortopedik muayenede ekstremitelerde kırık ve çıkık bulgusuna rastlanılmadı. Muayene sırasında ağrı tepkileri verdiği izlendi. Olgunun alınan torakal LL, VD ve abdomen LL radyografilerinde vertebralar arasında kemik üremeleri olduğu tespit edildi. Torakal ve lumbal T3-T4, T4-T5, T5-T6 ve L2-L3, L4-L5, L6-L7 omurlar arasında köprüleşme şeklinde kemik üremeleri gözlendi. Tedavide Prednol 2 mg/kg dozunda ilk gün IV sonraki iki gün IM yapıldı. Gün aşırı B-kompleks vitamin desteği sağlandı ve fizik tedavi önerildi. Sonuç olarak nadir olarak rastlanan kranial torakal spondilozis deformans olgusunun klinik hekimliği yapan meslektaşlarımızla paylaşmanın klinik pratiğe katkı sağlayacağı düşünülmektedir.The material of this case report was consisted of a 5-years-old boxer male dog. In the anamnesis information obtained, it was learned that the patient was reluctant and felt pain while walking and going up and down the stairs, had incoordination disorder in the front extremities, and walked wobbly. In the clinical and orthopedic examination, no fracture or dislocation findings were found in the extremities. It was observed that he gave pain responses during the examination. In the thoracic LL, VD and abdominal LL radiographs of the patient, bone growths were detected between the vertebrae. Bone growths in the form of bridging were observed between the thoracic and lumbar T3-T4, T4-T5, T5-T6 and L2-L3, L4-L5, L6-L7 vertebrae. In the treatment, Prednol was administered at a dose of 2 mg/kg, IV on the first day and IM on the next two days. Every other day, B-complex vitamin support was provided and physical therapy was recommended. As a result, it is thought that sharing a rare case of cranial thoracic spondylosis deformans with our clinical colleagues will contribute to clinical practice
Kontrastla indüklenen nefropatinin tavşan modelinde curcuminin koruyucu etkisinin araştırılması
To evaluate the effects of curcumin on contrast nephropathy in rabbits.MATERIAL AND METHODS: In this study, 14 adult, 2.5-3 kg white male New Zealand rabbits were randomly divided into 3 groups. Goups consisted of the control group (n=2) consisted of the contrast-induced nephropathy group (n=6) and the Curcumin group (n=6). In the curcumin group, curcumin was administered via gastric gavage at a dose of 500 mg/kg one day before and on the day of contrast agent administration. Iopromide was injected intravenously at a dose of 8 g/kg via a catheter in the V. auricularis marginalis over a period of 30 minutes at a slow rate to induce contrast nephropathy. Myeloperoxidase was 4,899 ± 0,424 ng/ml at hour 0 in the contrast-induced nephropathy group and a significant increase was observed after 48 hours (7.467 ± 0.353 ng/mL) (p=0.002). In the contrast-induced nephropathy group, vacuolization of the glomeruli, vacuolar degeneration of the tubular epithelial cells, hyaline casts, necrotic tubular epithelial cells in the tubules was statistically higher compared to the curcumin groups (P=0.000). Based upon these results, it was concluded that curcumin, which is a strong antioxidant, had a significant protective effect against contrast-induced nephropathy after 24 and 48 hours.Tavşanlarda curcuminin kontrast nefropatisi üzerine etkilerinin araştırılması.GEREÇ VE YÖNTEM: Bu çalışmada 14 yetişkin, 2,5-3 kg beyaz erkek Yeni Zelanda tavşanı rastgele 3 gruba ayrıldı. Gruplar kontrol grubu (n=2), kontrastla indüklenen nefropati grubu (n=6) ve Curcumin grubundan (n=6) oluşturuldu. Curcumin grubunda kontrast madde verilmesinden bir gün önce ve kontrast maddenin verildiği gün 500 mg/kg Curcumin gastrik gavaj ile uygulandı. İopromid kontrast nefropatisini oluşturmak için 30 dakikalık süre boyunca Vena auricularis marginalise bir katater yerleştirilerek 8 g/kg dozda intravenöz olarak enjekte edildi. Kontrastla indüklenen nefropati grubunda Miyeloperoksidaz düzeyi 0. Saatte 4,899±0,424ng/ml bulunurken 48 saat sonra anlamlı bir artış (7,467±0.353 ng/ml) gözlendi (p=0,002). Kontrastla indüklenen nefropati grubunda glomerüllerin vakuolizasyonu, tübüler epitel hücrelerinin vakuoler dejenerasyonu, hiyalin silindirleri ve tübül lümeninde tübüler nekroz Curcumin grubuna göre istatistiksel anlamlı olarak yüksekti (P=0,000). Bu sonuçlara dayanarak, güçlü bir antioksidan olan Curcuminin 24 ve 48 saat sonra kontrastla indüklenen nefropatiye karşı önemli bir koruyucu etkiye sahip olduğu sonucuna varıldı. Bu nedenle kontrast maddelerin kullanılmasından önce Curcumin uygulanması, seçilmiş vakalarda kontrastla indüklenen nefropatiyi önlemek için yararlı olabilir
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
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