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The Toronto General Hospital Transitional Pain Service: development and implementation of a multidisciplinary program to prevent chronic postsurgical pain

Joel Katz1 Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada;2 Department of Psychology, York University, Toronto, ON, Canada;3 Department of Anesthesia, University of Toronto, Toronto, ON, CanadaCorrespondence[email protected] [email protected]

Aliza Weinrib1 Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada;2 Department of Psychology, York University, Toronto, ON, Canada

Samantha R Fashler2 Department of Psychology, York University, Toronto, ON, Canada

Rita Katznelzon1 Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada;3 Department of Anesthesia, University of Toronto, Toronto, ON, Canada

Bansi R Shah1 Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada

Salima SJ Ladak1 Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada

Jiao Jiang1 Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada

Qing Li1 Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada

Kayla McMillan1 Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada

Daniel Santa Mina5 Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON, Canada;6 Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada

Kirsten Wentlandt4 Palliative Care, University Health Network, University of Toronto, Toronto, ON, Canada;7 Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada

Karen McRae1 Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada;3 Department of Anesthesia, University of Toronto, Toronto, ON, Canada

Diana Tamir1 Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada;3 Department of Anesthesia, University of Toronto, Toronto, ON, Canada

Sheldon Lyn1 Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada;3 Department of Anesthesia, University of Toronto, Toronto, ON, Canada

Marc de Perrot8 Division of Thoracic Surgery, Toronto General Hospital, York University, Toronto, ON, Canada

Vivek Rao9 Division of Cardiovascular Surgery, Toronto General Hospital, York University, Toronto, ON, Canada

David Grant10 Multiorgan Transplant Program, Toronto General Hospital, York University, Toronto, ON, Canada

Graham Roche-Nagle11 Division of Vascular Surgery, Toronto General Hospital, York University, Toronto, ON, Canada

Sean P Cleary12 Division of General Surgery, Toronto General Hospital, York University, Toronto, ON, Canada

Stefan OP Hofer13 Division of Plastic Surgery, Toronto General Hospital, York University, Toronto, ON, Canada

Ralph Gilbert14 Division of Otolaryngology – Head and Neck Surgery, Toronto General Hospital, York University, Toronto, ON, Canada

Duminda Wijeysundera1 Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada;3 Department of Anesthesia, University of Toronto, Toronto, ON, Canada

Paul Ritvo15 Department of Kinesiology and Health Science, York University, Toronto, ON, Canada

Tahir Janmohamed16 ManagingLife, Toronto, ON, Canada

Gerald O’Leary1 Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada;3 Department of Anesthesia, University of Toronto, Toronto, ON, Canada

Hance Clarke1 Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada;3 Department of Anesthesia, University of Toronto, Toronto, ON, CanadaCorrespondence[email protected] [email protected]

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Figures & data

Figure 1 Schematic illustration of the processes involved in the development of chronic postsurgical pain and pain disability showing relationships among preoperative, intraoperative, and postoperative risk/protective factors. Copyright © 2009 Katz and Seltzer. Adapted with permission from Katz J, Seltzer Z. Transition from acute to chronic postsurgical pain: risk factors and protective factors. Expert Rev Neurother. 2009;9(5): 723–744.^Citation3

Abbreviations: QoL, quality of life; SNRIs, serotonin–norepinephrine reuptake inhibitors; NSAIDs, nonsteroidal anti-inflammatory drugs; NMDA, N-Methyl-D-aspartic acid.

Table 1 Table of surgical procedures for patients enrolled in the Transitional Pain Service

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Table 2 Transitional Pain Service (TPS) referral criteria

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The Toronto General Hospital Transitional Pain Service: development and implementation of a multidisciplinary program to prevent chronic postsurgical pain

Table 1 Table of surgical procedures for patients enrolled in the Transitional Pain Service

Table 2 Transitional Pain Service (TPS) referral criteria

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The Toronto General Hospital Transitional Pain Service: development and implementation of a multidisciplinary program to prevent chronic postsurgical pain

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Table 1 Table of surgical procedures for patients enrolled in the Transitional Pain Service

Table 2 Transitional Pain Service (TPS) referral criteria

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