Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries
Authors:   TASMAN Collaborative, Xu William , Liu Gordon , Varghese Chris , Wells Cameron , Smith Nicolas , Windsor John , Gaborit Lorane , Goh Sarah , Basam Aya , Elhadi Muhammed , Soh Rachel TingQian , Saeed Umar , Abdulwahed Eman , Farrell Michael , Wright Deborah , Martin Jennifer , Pockney Peter , Xu William , Basam Aya , Goh Sarah , Li Jiting , Shah Jainil , Waraich Abdullah , Gaborit Lorane , Pathak Upasana , Hilder Amie , Elhadi Muhammed , Jabur Aiden , Kalyanasundaram Kaviya , Ohis Christina , Ong Chui Foong , Park Melissa , Siribaddana Venesa , Raubenheimer Kyle , Vu Jennifer , Wells Cameron , Liu Gordon , Ferguson Liam , Xu William , Varghese Chris , Pockney Peter , Atherton Kristy , Dawson Amanda , Martin Jennifer , Banerjee Arnab , Dudi-Venkata Nagendra , Lightfoot Nicholas , Ludbrook Isabella , Peters Luke , Sara Rachel , Watson David , Wright Deborah , Adeyeye Ademola , Alvarez-Lozada Luis Adrian , Atici Semra Demirli , Buhavac Milos , Calini Giacomo , Elhadi Muhammed , Ioannidis Orestis , Tepe Mustafa Deniz , Nath Upanmanyu , Uzair Ahmad , Yang Wah , Zaidi Faseeh , Singh Surya , Abdullah Bahiyah , Palacios Diana Sofia Garces , Ragab Ahmed , Ahmed Ahmed , Raubenheimer Kyle , Daudu Davina , Goh Sarah , Benyani Simran Vinod , Karthikeyan Nandini , Mansour Laure Taher , Seow Warren , Tasi Zoya , Jabur Aiden , Pathak Upasana , Park Melissa , Abdelmelek Dhia Errahmane , Boussahel Ikram Fatima Zohra , Kaabache Oumelaz , Lemdaoui Naoual , Nebbar Oualid , Rais Mounira , Abdoun Meriem , Kouicem Aya Tinhinane , Bouaoud Souad , Bouchenak Kamel , Saada Hind , Ouyahia Amel , Messai Wassila , Choong Zhi Shyuan , Ting Clarissa , Larkin Michelle , Fong Pei Jun , Soh Isabel , De Grandi Alyssia , Iftikhar Hareem , Sinha Akansha , Kapoor Dhruv , Chlebicka Tara , Singer David , Goddard Kim , Matthews Lisa , Lin Rosalina , Chambers Jessica , Chan Juliet , Macnab Brooke , Barker John , Mckenzie Morgan , Ferguson Neil , Juwaheer Ghanisht , Muralidharan Vijayaragavan , Gill Sonia , Sung Nakjun , Patel Rohan , Walters Chris , Nguyen Kevin , Liu David , Cabalag Carlos , Lee Jennifer , Leow San-Hui Anita , Ng Suat Li , Ashraf Hamza , Mulder Fraizer , Loo Jonathan , Proud David , Wong Samantha , Zhou Yida , Soh Qi Rui , Chye David , Stevens Sean , Tang Patrick , Kritharides Stephen , Dong Jason , Morice Oscar , Huang Dora , Hardidge Andrew , Amarasekara Mishka , Kink Aleah , Bolton Damien , Rawal Alisha , Singh Jasraaj , Heard Matthew , Hassan Yusuf , Naqeeb Ahmed , Cobden Andrew , Prinsloo Duron , Quadros Dwain , Gunn Emma , Kim Ha Jin , Ekwebelam Jennifer , Shanahan James , Alkazali Mustafa , Hoosenally Mariyah , Nara Naveen , Nguyen Peter , Barker Sally , Tamsett Zacchary , Rigby Naomi , Patel Hinal , Ferguson Eloise , Byrnes Lauren , Bravo Alexander , Hilder Amie , Hui Ally , Karmakar Antara , Wang Bill , Goonawardena Janindu , Cheung King Tung , Chan Nicholas , Natarajan Ragul , Cade Richard , Jin Rong , Sengupta Shomik , Snider Ruth , Morisetty Harsha , Weeda Lewis , Sun Phoebe , Chilaka Lalitya , Cover Jacinta , De Silva Abeweera Gunasekara Aashrinee , Senthilrajan Rahavi , Alwahaib Anas , Limmer Alexandra , Zamanbandhon Bushra , Jaffry Kumail , Shen Yijia , Chua Alan , Syed Saifulla , Saha Sushanth , Glynatsis John , Aitchison Lori , Lagana Bernard , Crossman Mason , Watson David , Dawson Abby , Fong Bryan , Harrison Ella , Horsburgh Eleanor , Glynatsis John , Khoo Michael , Mishra Kritika , Hewton Lewis , Mesecke Alex , Tu Hien , Tun Than , Wong Jason , Ong Elynn , Law Tara-Nyssa , Landy Ashlee , Leano Alyssa , Li Andrea , Soni Akshay , Dowdle Benjamin , Pilgrim Charles , Abeysirigunawardana Dewmi , Jeyarajan Deepak Rajan , Patel Diya , Chung Jason , Mckinnon Kyle , Gould Madeline , Gilmore Paul , Geng Ruxi , Loughnan Rachael , Norton-Smith Sarahjane , Nyame Solomon , Tan Sarah , Samarawickrama Sewni , Yoon Si Woo , Wang Yantong , Zhang Yichi , Wang Zixuan , Mare Hans , Withanage Indrajith , Khattar Mitali , Toft Alexandra , Sivasuthan Goutham , Zhao Hailin , Addley Jordan , O'brien Lucinda , Raza Muhammad , Bindra Randipsingh , Sharma Sonakshi , Cornwell Charlotte , Patil Aditya , Cheung Aiden , Lown Ashleigh , Dawson Amanda , Blassey Aneel , Ochigbo Benjamin , Cheng Felicity , Fatima Aleeza , Zhang Edward , Kocatekin Henry , Roth Charles , Brewster Dani , Kwok Kelvin , Chen Paul , Laura Sharon , Tynan Dominic , Latif Edward , Lun Elizabeth , Honore Elodie , Ziergiebel Felix , Blake Jessica , Chandiok Karan , Bird Katie , Ngothanh Lynette , Lee Melissa , El-Masry Mariam , Hamer Peter , Palaniappan Ramanathan Rm , Mcgee Richard , Huang Sarah , Zhang Shane , Hariharan Shubhang , De Silva Yannick , Lee Celeste , Fotheringham Penelope , Incoll Ian , Cordingley Timothy , Cheng Felicity , Brown Matthew , Kang Leannedra , Wijayaratne Rivindu , Moore Parisse , Qian Gemma , Elgindy Yara , Carnuccio Emma , Rae Hamish , Shehata Mena , Liu Mingchun , Lockwood Brodee , Van Bockxmeer John , Alsoudani Ali , Swan Daniel , Hsieh Justin , Orchard-Hall Francesca , Tay Kai Yun Jodene , Mehra Raagini , Gebeh Alpha , Bailey Ashley , Brown Georgia , Colaco Ashley , Gopal Hemashree , Boyley Jessica , Changati Varun , Fletcher Joseph , Khandelwal Tanishq , House Colin , O'neil Chris , Jaarsma Emily , Ly Victor , Balogh Zsolt , Shui Amanda , Sathasivam Vinogi , Legge-Wilkinson Hannah , Wong King Ho , Chen Andrew , Tran Anthony , Rehfisch Peter , Wang Grace , Nguyen Jonathan , Peker Joshua , Gallert Kayla , Komesaroff Mia , Namburi Manideep , Goldfinch Elisabeth , Muchabaiwa Ropafadzo , Jangam Aishwarya , Taylor Isobel , Nusem Iulian , Park Jin Hyuk (David) , Gundara Justin , Heigan Rachael , Tran Tam , Mackay Thomas , Butterworth Yasmine , Sadauskas Tomas , Tung Melody , Ellepola Hasthika , Gan Christine , Fong Hakim , Das Ankita , Naicker Leshya , Hauptman Samantha , Kamath Aditi , Yew Anthea , Parange Anupam , Kim Katie , Kharwadkar Sahil , Gamage Tharushi , Vance Lucille , Seldon Alexandra , Ghaly Moheb , Shah Jainam , Phan Victoria , Chauhan Karanjeet , Bassam Ahmad , Vollenhoven Beverley , Jaffry Kumail , Mandhan Kajal , Sritharan Mithra , Sakthivel Mahesh , Evans Natalie , Robinson Samuel , Sivakumar Seiyon , Marrison Liberty , Jollow David , Joshi Krishma , Tao Steve , Shrestha Pallavi , Nukala Sai Keerthana , Hodgson Russell , Crotty Anna , Esho Adriana , Harris Alasdair , Surkitt Amy , Bland Laura , Mcleod Blake , Yin Chonghao , Keng Cambo , Greenwood Emily , Yuan Grace , Haege Emma , Wu Hongyi , Xiao Haotian , Pozzi Isabella , Fu Jeff , Ross Jessica Stott , Gentle Juliette , Gan Kathy , Chang Kelvin , Sun Kexin , Singh Madhavi , Xie Maria , Mccabe Nicholas , Slavec Mark , Clarnette Nick , Niknami Behzad , Zou Peishan , Flintoft Sean , Jayatilleke Shenuka , Sok Rumnea , Tan Suqi , Wadhwa Sanya , Swansson Will , Abulafia Daniel , Blundell Jian , Sweetapple Amie , Del Solar Caitlin , Martin Cameron , Bell David , Fernando Isuru , Chang Jared , Vanzuylekom Katie , Van Zuylekom Katie , Van Zuylekom Kate , Hobbs Katie , Liang Richard , Jabur Aiden , Tarmidi Jazmina , Ugool Mahmoud , Beatson Nicholas , Bowman Sarah , Moin Sophie , Tan Wen Po Jonathan , Chidambaram Seevakan , Gan Siang Wei , Wang Pengnan , Naicker Leshya , Kim Katie , Wang Nicole Qiwen , Kwan Yi Xin , Patil Chinmai , Joshi Divyanshu , Kamath Aditi , Hanan Aishath , Sheriff Arfaan , Duffield Jaime , Naiker Leshya , Smitham Peter , Neo Eu Ling , Chua Matthew , Prasad Shalvin , Nagaratnam Armitesh , Sammour Tarik , Lin Yuxin , Lee Christine , Hopping Eve , Jangra Muskan , Das Ankita , Lin Ken , Bunjo Zachary , Raubenheimer Kyle , Yunos Mohamed Haseef Mohamed , Yeung Kar Long , Phu Rachel , Betts Aisling , Just Benjamin , Gera Sahil , Leeson Hilary , Jamieson Jodie , Wang Katie , Luu Emily , Innes Michael , Vu Jennifer , Hong Jonathan , Dzator Stephen , Flame Aki , Jiang Vincent , Kwok Jianing , Lawrence Aaron , Meads Kate , Pearce Liam , Sarangadasa Pavatharane , Shaw Haylee , Yu Victor , Crostella Elizabeth , Wong James , Bobba Sriya , Muller Maddison , Hau Yin Chi Hebe , Wilson Thomas , Markovic Aleksandra , Green Jemma , Forbes Clara , Burrows Emalee , Hou Lachlan , O'sullivan Clare , Foo Jonathon , Greig Hannah , Collins A-J , Chandler Callum , Heaney Emily , Gross Hannah , Morgan Monica , Loder Rebecca , Rajesh Krishnankutty , Ananthapadmanabhan Shravankrishna , Razmi Akeedh , Vong Crystal , Pothukuchi Prasanna , Theophilus Mary , Sriranjan Roshni , Kaur Sharon , Kanczuk Marcelo , De Groot Julia , Corrigan Angela , Li Damon , Badri Danniel , Ciranni Dominico , Needi Elangovan Thaya , Clanfield Matthew , Copertino Nicolas , Rumble William , Vanguardia Maria Kristina , Lew Chen , Dennaoui Rami , Shah Jainil , Kong Joseph , Koh Imogen , Zeng Raymond , Baziotis-Kalfas Kristian , Denby Hannah , Li Andy , Tran Will , Singh Abhinav , Lin Olivia , Chau Michelle , Donaldson Olivia , Min Christina (Seojung) , Ballah Shirahn , Tsui Sonia Ching Ting , Yong Nathania , Standish Lucy , Tan 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Arkan , Tang Howard , Keenan Rory , Chan Alex , Canny Mitch , Tahir Farah , Egerton James , Yeung Justin , Chan Justin , Tiffany Lea , Bei Michael , Raj Mariolyn , Williams Peter , Nagpal Sakshar , Outhred Tim , Krawitz Russel , Choi Colin Chan-Min , Younus Khadijah , Giurgius Mary , Kirk Rosemary , Pegorer Amanda Gonzalez , Tang-Ieam Pattarapan , Ward Jack , Wijetunga Asanka , Zhang Caitlin , Nahm Chris , Wang Christine , Golja Damian , Jenkins Gregory , Qian Helena , Luong Jason , Nguyen Kim , Suttor Sean , Lai Sherman , Ma Vanessa , Chen Yan , Yu Hoi Hang , Lee Amos , Barbaro Antonio , Mcguinness Cameron , Maddern Guy , Young Stevie , Lim Ye Fang , Trotta Georgina , Chao Phoebe , Ding George , Fang Carol , Lu Andi , Wagaarachchi Prabhath , Cornwell Charlotte , Gojnich Amy , Stewart Peter , Dong Isabella , Wong Kenneth , Burruso Luca , Hogan Lucinda , Mcorist Nathan , Singh Ramnik , Jeyamohan Ragavi , Hou Zhen , Lai William , Taylor Emily , Palacios Diana Sofia Garces , Pantoja Maria 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Mohamed A , Hares Mohamed M , Abdelfatah Mohammed Abdelnasser , Abughanima Mahmoud , Abdeljaber Mahmoud , Saber Mona , Amin Mostafa K , Abbas Mostafa , Haroon Ola , Khalil Omaima , Talaat Omnia , Elnagar Rahma , Soliman Randa , Aboelela Reham , Salah Salem , Abdelgawad Samia , Mohammed Tasneem , Hussien Tarek A , Sobhy George , Sayed Yasmeen , Silem Yousra Othman Reham , Dawood Ali , Hemaida Tarek , Ahmed Reem , Kamaleldin Aya , Zakaria Ahmed , Salah Mohamed , Salem Ebrahim , Rashed Osama Fathy Ali Ali , Halawa Mohamed , Elfeki Hossam , Mosaad Abdelrahman , Shaaban Abdelrahman , Abdelsalam Hebatalla , Sakr Ahmed , Sanad Aly , Elsawy Amr , Maged Bassant Maged , Hegazy Dana , Abdelmaksoud Mohamed , Laymon Mahmoud , Taman Mohamed , Moawad Esraa R , AboElfarh Hadeer Elsaeed , Elkenawi Karim , Osama Manar , Sadek Mirna , Elghazy Mohamed Abdelaziz , Attia Mohamed , Nader Mohamed , Shalaby Mostafa , Attiya Omar , Gaarour Osama Samir , Zaghloul Ahmed , Mikhail Pola , Badr Karim , Soltan Hatem 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, Al-Tahayneh Sief-Addeen , Alsheik Ahmad , Sawaftah Khaled , Sarhan Osama , Alkhatib Abed Alazeez , Alzghoul Bader , Saleh Ahmad , Yaghmour Jamal , Shahin Mahmoud , Maali Mohammed , Alatefi Dawood , Al-Smirat Heba , Hezam Abdulhakim , Alathameen Nassar , Kaddah Abdulrahim Al , Al Hammoud Amr , Ayasrah Salem , Abuuqteish Hamza , Al-Mwajeh Tesneem , Makableh Reena , Bataineh Saad , Shabaneh Amin , Alnatsheh Wesam , Aldeges Marwan , Hamad Huda , Shehahda Sireen , Khassawneh Dima , Alzyoud Osama , Alrosan Risan , Awad Hasan , Khaldoon Tariq , Shannaq Rabab , hamoud Mohammad Al , fadalah Bader Abo , Al-Hazaimeh Mo'ath , Khraise Wail , Alnajjar Lara , Alnajjar Majjd , Al-Omary Sohaib , Ababneh Adnan , Albashaireh Alaa , Khadrawi Mohammad , Aljamal Mohammad , Athamneh Tayseer , Muqbel Ro-a , Al-jammal Maryam , Masarrat Ahmad , Al-zawaydeh Alia , Taha Ibrahim , Qattawi Taima’ , Smadi Rayyan , Alhaleem Ayah , Alboon Mosab , Hazaymeh Omar , Karasneh Leen , Al-Haek Safa’ , Almahroush Marin , 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Fearnley-Fitzgerald Chekodi , Wright Deborah , Ghandi Kushan , Matheson Natalie , McGuinness Matthew James , Chen Brian , Douglas Rebecca Indiana , Richter Konrad , Soliman Nisha Bianca , Bolam Scott Matthew , Vimalan Vineeth , Currie William , Cuthbert Mitchell , Ross Poppy , Nicholson Amy , Garton Briar , Agnew Emilie , Conlon Niamh , Waaka Nicholas , Kejriwal Ritwik , Nguyen Sean , Leung Edmund , Ratnayake Milidu , Smith Quintin , Joseph Nejo , Yue Bosco , Fraser Calvin , Lam Charles , Figgitt Ethan , Liu Gordon , Tan Kevin , You Ha Seong , Zheng Helen , Luo Jenny , Sharp James , Khanna Kabir , Simiona Levi , Luo Michel , Ratnayake Milidu , Wong Patrick , Luu Rebecca , Paul Rohit , Nair Shiva , Asadyari-Lupo Shadie , Hung Wing , Ying Geoffrey , Ho Jess , Wu Alan , Walsh Eamon , Lee Jouyee , Liu Jessie , Yao Sunny , Nosseir Omar , Dang Jennifer , Young Simon , Zyul'korneeva Sof'ya , Boyd Theresa , Ho Jess , Wu Alan , Yao Sunny , Kirfi Abdullahi Musa , Ningi Adamu Bala , Garba Mohammad Albuhari , Salihu Makama Baje , Ukwuoma Ohia Ernest , Ibrahim Abdullahi , Sajo Isa Mienda , Aminu Muhammad Baffah , Usman Liman Haruna , Lanre Oloko Nasirudeen , Shuaibu Ibrahim Shaphat , Yusuf Stephen , Ismail Tiamiyu , Umar Gabi Ibrahim , Adeyeye Ademola , Afeikhena Ehis , Nnaji Favour Chinenye , Agu Joy Onyekachi , Maxwell Temiloluwa Peace , Motajo Oluwatosin Olakunle , Ifoto Oghenekaro , Okon Seubong-Abasi Imoh , Makama Jerry Godfrey , Mohammed-Durosinlorun Amina Abosede , Aminu Bashiru , Onwuhafua Polite Iwedike , Mohammed Caleb , Abdulrasheed Lubabatu , Adze Joel Amwe , Suleiman Khadijah Richifa , Airede Lydia Regina , Taingson Mathew Chum , Bature Stephen Bodam , Kache Stephen Akau , Ogbonna Uchechukwu Ohijie , Fufore Mohammed Bello , Iya Abdulkarim , Ajulo Adeshina A , Mahmud Ahmad , Yahya Bilal Shuaibu , Onimisi-Yusuf Farida , Isaac Hope , Jawa Timothy , Joseph Fashe , Kala Bemi , Bakari Maisaratu A , Ngwan David Wujika , umar Abubakar , Filikus Abraham L , Wycliff Daniel , Okunlola Abiodun , Abiola Olukayode , Adeniyi Adebayo , Adeyemo Olabisi , Awoyinka Babatunde , Babalola Olakunle , Bakare Adewumi , Buari Taiwo , Okunlola Cecilia , Adeleye Gbadebo , Salawu Adedayo , Abiyere Henry , Ogidi Adetolu , Orewole Tesleem , Abdullahi Habiba Ibrahim , Akaba Godwin , Achem Arome , Bassey Asi-oqua , Ayogu Emeka , Sulaiman Bilal , Isah Dennis Anthony , Akpamgbo Chukwunonso Nnamdi , Asudo Felicia , Adewole Nathaniel , Oguche Omachoko , Ejembi Peter , Sani Samuel Ali , Andrew Paul Chimezie , Isah AliyuYabagi , Eniola Bolarinwa , Songden Zumnan , Agida Teddy , Atim Terkaa , Mohammed Taofiq Olayinka , Raji Hadijat Olaide , Ibiyemi Femi , Salawu Hafeez , Fasiku Olushola , Solagbade Remi Sanyaolu , Shiru Mariam Motunrayo , Ibraheem Gbadebo Hakeem , Oruade Justina , Ezeoke Grace , Chawla Tabish , Aziz Aliya Begum , Marium Anoosha , Waheed Ayesha Akbar , Aamir Faiqa Binte , Qureshi Faiza , Ather M Hammad , Ali Iqra Fatima Munawar , Tahir Izza , Akbar Maha Ghulam , Ukrani Ronika Devi , Raja Sajjan , Virani Sehar Salim , Noordin Shahryar , Rehman Saif Ur , Golani Shalni , Aamir Syed Roohan , Mufarrih Syed Musa , Waqar Usama , Taufiq Maliha , Ammar Ahmed Siddique , Ejaz Adya , Sarwar Albash , Khalid Ahmed Usman , Khattak Shehrbano , Imran Aliza , Khalid Omer Bin , Kaleem Urauba , Muneer Urwah , Kashaf Yumna , Zafar Fatima , Zaheer Adil , Ali Muhammad , Shafaat Amna , Qazi Arisha , Tariq Asjad Imran,Mahnoor , Aslam Muhammad Nadeem , Ali Shehroz , Atiq Tabish , Wasim Tayyiba , Babar Daniyal , Zain Ahmad , Ibtisam Muhammad , Ahmed Uzair , Aqeel Syed Talha Bin , Muhib Muhammad , Abbal Muhammad Anas , Khan Nasar Ahmad , Javed Imran , Alkaraja Layth , Amro Dana , Manasrah Ghaida , Hammouri Ibraheem , Hilail Ihab Abu , Zalloum Jihad , Alamlih Laith , Nasereddin Mahmoud , Rajabi Munia , Shalalfeh Sa'ed , Natsheh Zeinab , Elessi Khamis , Jayyab Mustafa Abu , Astal Mohammed , Al-Dahdouh Mosheer , Salameh Alaa Eddin , Ayyad Alaa , Dawod Nimatee , Alsaid Hamza , Matar Iyas , Hassan Majd , Bakeer Mohammed , Malasah Mohammad , Abuhashem Shehab , Salem Mohammed , Lunca Sorinel , Dimofte Mihail Gabriel , Morarasu Stefan , Musina Ana Maria , Roata Cristian Ene , Velenciuc Natalia , Butyrskii Aleksandr , Bozhko Maxim , Ametov Amet , Chowdhury Sharfuddin , Bagazi Doaa , Domenech Julio , Rosello-Añon Alejandro , Monis Ana , Chiappe Caterina , Cuneo Beatriz , Clemente-Navarro Pablo , Febre Jorge , Sanz-Romera Jorge , Lopez-Vega Marcos , Miranda Ignacio , Valverde-Vazquez Rocio , Garcia Sara , Sanguesa Maria Jose , Balciscueta Zutoia , Ruiz Enrique , Marco Eduardo , Talavera Elena , Farre Joan , Bacariza Loreto , Duart Mireia , Ureña Violeta , Carre Xenia , Hamid Hytham K S , Abd-Albain Montasir A , Galal-Eldin Sami , Sarih Monira , Adam Eithar , Ismail Samir , Azhari Malaz , Hassan Tawfieg , Salaheldein Mohamed , Abdalla Zainab , Ahmed Wahiba , Alhassan Monzer , Mohamed Abdulatif , Suliman Hozifa Mohamed Abdalla , Eltayeb Mohammed Omer Mohammed , Ahmed Rogia Ahmed Abdalla , Babekir Enas Mohammedtom Abdulhameed , Khairy Munya Ali Talab , Mukhtar Maha Mukhtar Ahmed , Ali Rzan Ali Hamedelneel , Al-Shambaty Yasir Babkir Ali , Yousif Fatima Imad , Mohammed Hawa Mohammed Hassan , Osher Lana , Osher Lana , Abdelbast Menhag , Yassin Mohamed , Moawia Noon , Abdalsadeg Rowa , Husein Abrar , Elhassan Baraa , Abdelbagi Alnazeer Y , Adam Mohammed A , Ali Eithar M , Mohammed Ibrahim A b , Mohamed Maab , Abdulaziz Mohamed , Akasha Mazin , Hassan Muaz , Hilal Nadir , Mohamed Noon Abdalla Abdelrahman , Abubaker Noora , Mohammed Omeralfarouk , Mohamed Shakir , Osman Walaa , Mustafa Fatima , Salih Alaa A , Ali Doua , Almakki Doha Mohammed Ahmed , Mohamed Hanan Elnour , Elmubark Abdelhadi , Hassan Mohamed , Alnour Ammar , Elaagib Amna , Abdelrahman Ayman , Abdelkhalig Mubarak , Eldaim Khalid Nour , Babiker Afra , Ahmed Entisar , Ali Maab , Hussain Eman , Wedatalla Mansour , Ahmed Alaaaldeen , Hamza Alla Aldeen , Mohammed Mohab , Osman Omer , Ibrahim Reham , Ahmed Rihab , Ahmed Ruaa , Yasir Ruaa , Awadallah Safaa , Mohmmed Sara , Hassan Suhaib , Shaban Walid , Hussein Aisha , Rafea Reem , Abdalla Ahmed , Ahmed Abdalla , Mohamed Khalid , Mohammed Mansour , Altahir Mohamed , Adam Mohammed , Mohamed Omer , Abdullah Walaa , Fadlalmola Hammad , Abdalla Ahmed Yassir , Omer Ahmed Ali , Mustafa Ahmed Alfatih , Elhadi Rawan Elnoman Hamadelniel , Banaga Essam Eldien Abuobaida , Osman Fatima , Abdalla Mohamed Galal Ali , Taha Hala Abdelhalim Mohamed , Abdalmahmoud Noon Ezzeldien , Nafie Rofuida Hussien , Jamal Sami , Ahmed Sharwany , Ali Rawan Alsheikh , ‏Aladna ‏Abdallah , ‏Aljoumaa ‏Abdullah , ‏Nawfal ‏Hamdi , Jamali Salma , Khouja ‏Fatima , ‏Niazi ‏Ammar , Al Rawashdeh Toka ‏ ‏ , Kechiche Nahla , Gara Mouna , Nasr Mouna , Baccar Marwen , Benamor Oumayma , Chakroun Sawssen , Sanli Ahmet Necati , Yildiz Ahmet , Demirkiran Mehmet Ali , Atadag Yildiz Buyukdereli , Tandogan Yusuf Iskender , Ozkan Esin , Ozer Yıldırım , Ozkan Esin , Oncel Muhammed Miran , Kalkan Senad , Gover Tolga , Manoglu Berke , Oksak Ilayda , Kurt Ipek , Rifaioglu Kerem , Sokmen Selman , Bisgin Tayfun , Yildirim Yasemin , Keskin Abdil Yetkin , Dogan Tugce , Sahin Berfin İlgaz , Aydin Cemil , Benek Duygu Ece , Tiras Hale Nur , Arslangilay Mert , Aslangilay Mert , Yaytokgil Muhammet , Capar Mehmet Ali , Yazgan Yasemin , Bektas Sebnem , Alagoz Ahmet Can , Dagsali Alara Ece , Izgis Aylin , Uzel Kadir , Soytas Mustafa , Cakir Niyazi , Askin Abdullah Emre , Azboy Ibrahim , Sabuncu Kubilay , Aslan Merve , Sahin Melek , Oncel Mustafa , Okkabaz Nuri , Sivrikaya Ramazan Kemal , Saylar Alparslan , Saylar Alparslan , Yasar Meltem , Erginoz Ergin , Bozkir Haktan Ovul , Zengin Kagan , Ozcelik Mehmet Faik , Uludag Server Sezgin , Ozdemir Zeynep , Sibic Osman , Telci Hatice , Bozkurt Mehmet Abdussamet , Kara Yasin , Tepe Mustafa Deniz , Gündoğdu Adnan , Akın Bilge , Pehlivan Dilan , Guner Ali , Baysallar Duygu , Yıldız Berkay , Cepe Hale , Reis Murat Emre , Yuzgec Ayse Nilufer , Kıralı Nurtac , Kodalak Taha Anıl , Ulusahin Mehmet , Selim Kamar , Kale Ahmet , Gecici Mehmet Emre , Ozbilen Melis , Düzyol Zeynep , Gemici Aylin , Korkmaz Elzem , Şen Eminenur , Taşcı Muhammed Enes , Camkıran Elifsu , Elieyioğlu Güşta , Kayabaş İkbal , Uprak Tevfik Kıvılcım , Aral Canan , Saraçoğlu Ayten , Uğurlu Mustafa Ümit , Baltacı Zeynep Hazal , Akkaya Ege Nur , Fergar Cem , Tabak Elif Zeynep , Kocyigit Guldane Zehra , Kayilioglu Ilgaz , Polat Süleyman , Çolak Eli˙f , Kara Mehmet Emin , Candan Mert , Uyanık Mustafa Safa , Sarı Ahmet Can , Ulkucu Attila , Certel Alperen Taha , Dindar Arzu , Durdu Beyza , Bayram Cigdem , Kaya Eslem , Akdere Hakan , Cakcak Ibrahim Ethem , Yavuz Ikranur , Omur Mert , Ajredini Mirac , Aydoğdu Erhan Onur , Şenödeyici Eylül , Koksoy Ulku Ceren , Kazbek Baturay Kansu , Korkmaz Deniz Serim , Yavuz Dogancan , Yilmaz Hakan , Cetınkaya Zeynep Sahan , Durmus Elif , Tuzuner Filiz , Hokelekli Furkan , Mutlu Mucahid , Akbuz Seyma Orcan , Kus Ziya Can , Kus Ziya Can , Farrell Michael , Craig-Lucas Alayna , Painter Matthew , Titan Ashley , Narayan Aditya , Fariyike Bunmi , Knowlton Lisa , Yue Tiffany , Benham Emily , Nimeri Abdelrahman , Werenski Hope , Kaiser Nicole , Reinke Caroline 
Published: January 2024

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 &lt; 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 (β 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.