title: Chronic postsurgical pain and persistent opioid use following surgery: the need for a transitional pain service.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Anaesthesia, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada.|Transitional Pain Service, Department of Anesthesia, Toronto General Hospital, Toronto, Ontario, Canada.
authors.forename: Alexander
authors.initials: A
authors.lastname: Huang
authors.affiliation: Department of Anaesthesia, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada.|Transitional Pain Service, Department of Anesthesia, Toronto General Hospital, Toronto, Ontario, Canada.|Department of Psychology, York University, Toronto, Ontario, Canada.
authors.forename: Abid
authors.initials: A
authors.lastname: Azam
authors.affiliation: Department of Anaesthesia, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Shira
authors.initials: S
authors.lastname: Segal
authors.affiliation: Department of Anaesthesia, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Kevin
authors.initials: K
authors.lastname: Pivovarov
authors.affiliation: Department of Anaesthesia, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada.|Transitional Pain Service, Department of Anesthesia, Toronto General Hospital, Toronto, Ontario, Canada.
authors.forename: Gali
authors.initials: G
authors.lastname: Katznelson
authors.affiliation: Department of Anaesthesia, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada.|Transitional Pain Service, Department of Anesthesia, Toronto General Hospital, Toronto, Ontario, Canada.
authors.forename: Salima Sj
authors.initials: SS
authors.lastname: Ladak
authors.affiliation: Department of Anaesthesia, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada.|Transitional Pain Service, Department of Anesthesia, Toronto General Hospital, Toronto, Ontario, Canada.
authors.forename: Alex
authors.initials: A
authors.lastname: Mu
authors.affiliation: Department of Anaesthesia, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada.|Transitional Pain Service, Department of Anesthesia, Toronto General Hospital, Toronto, Ontario, Canada.|Department of Psychology, York University, Toronto, Ontario, Canada.
authors.forename: Aliza
authors.initials: A
authors.lastname: Weinrib
authors.affiliation: Department of Anaesthesia, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada.|Transitional Pain Service, Department of Anesthesia, Toronto General Hospital, Toronto, Ontario, Canada.|Department of Psychology, York University, Toronto, Ontario, Canada.|Department of Anesthesia, University of Toronto, Toronto, Ontario Canada.
authors.forename: Joel
authors.initials: J
authors.lastname: Katz
authors.affiliation: Department of Anaesthesia, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada.|Transitional Pain Service, Department of Anesthesia, Toronto General Hospital, Toronto, Ontario, Canada.|Department of Anesthesia, University of Toronto, Toronto, Ontario Canada.
authors.forename: Hance
authors.initials: H
authors.lastname: Clarke
mesh_terms: D000368:Aged; D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use*; D059350:Chronic Pain / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy* / Q000453:epidemiology; D057234:Preoperative Period
chemical_list: D000701:Analgesics, Opioid
keywords: chronic pain; chronic postsurgical pain; pain disability; persistent opioid use; postoperative pain; transitional pain service