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

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.