Chronic Postsurgical Pain and Persistent Opioid Use Following Surgery: The Need For A Transitional Pain Service

Abstract

Aim: To identify the 3-month incidence of chronic postsurgical pain and long-term opioid use in patients at the Toronto General Hospital. Methods: 200 consecutive patients presenting for elective major surgery completed standardized questionnaires by telephone at 3 months after surgery. Results: 51 patients reported a preoperative chronic pain condition, with 12 taking opioids preoperatively. 3 months after surgery 35% of patients reported having surgical site pain and 13.5% continued to use opioids for postsurgical pain relief. Postoperative opioid use was associated with interference with walking and work, and lower mood. Conclusion: Chronic postsurgical pain and ongoing opioid use are concerns that warrant the implementation of a Transitional Pain Service to modify the pain trajectories and enable effective opioid weaning following major surgery.

KEYWORDS:

• chronic pain
• chronic postsurgical pain
• pain disability
• persistent opioid use
• postoperative pain
• transitional pain service

Financial & competing interests disclosure

H Clarke is supported by Merit Awards from the Department of Anaesthesia at the University of Toronto. H Clarke is also supported by a Canadian Institutes of Health Research Fellowship. J Katz is supported by a Canadian Institutes of Health Research Canada Research Chair in Health Psychology at York University. MA Azam is supported by an Ontario Graduate Scholarship. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The authors state that they have obtained appropriate institutional review board approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.

Additional information

Funding

H Clarke is supported by Merit Awards from the Department of Anaesthesia at the University of Toronto. H Clarke is also supported by a Canadian Institutes of Health Research Fellowship. J Katz is supported by a Canadian Institutes of Health Research Canada Research Chair in Health Psychology at York University. MA Azam is supported by an Ontario Graduate Scholarship. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. No writing assistance was utilized in the production of this manuscript.