A world-first transitional pain program that aims to stop pain from becoming chronic after surgery is being pioneered at Toronto General Hospital, University Health Network.

The one-year pilot program is designed to treat complex pain patients who have had surgery by helping with pain control, monitoring and weaning patients off excessive amounts of opioid medications for pain, and providing much-needed support for patients after they are discharged from the hospital. Follow-up care is provided by a diverse team of clinicians who specialize in pain control. Program specialists are not aware of any other such program in scientific publications.

Poorly controlled postsurgical pain is a risk factor for hospital re-admission and increased use of health care resources.
The program, which began in June 2014, also hopes to answer compelling questions of which risk factors cause chronic pain, what works best to stop or modify the “pain pathway” for patients, and how interventions can prevent hospital re-admissions of complex patients after surgery.

“We want to break the cycle of pain with multiple pain strategies,” says Dr. Hance Clarke, Medical Director of the Pain Research Unit and Director of The Transitional Pain Service in the Anesthesia Department and Pain Management at Toronto General Hospital (TGH). He adds that after about three months, post-surgical pain can develop into chronic pain, therefore it is important to intervene before this happens. As many as 30% of surgical patients develop chronic pain after surgery, and are at an increased risk for long-term opioid use. 50% of patients after major surgery are discharged from hospital with a prescription for opioids.

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