Opioid weaning and pain management in postsurgical patients at the Toronto General Hospital Transitional Pain Service

ABSTRACTBackground: The perioperative period provides a critical window to address opioid use, particularly in patients with a history of chronic pain and presurgical opioid use. The Toronto General Hospital Transitional Pain Service (TPS) was developed to address the issues of pain and opioid use after surgery.Aims: To provide program evaluation results from the TPS at the Toronto General Hospital highlighting opioid weaning rates and pain management of opioid-naive and opioid-experienced surgical patients.Methods: Two hundred fifty-one high-risk TPS patients were dichotomized preoperatively as opioid naive or opioid experienced. Outcomes included pain, opioid consumption, weaning rates, and psychosocial/medical comorbidities.Results: Six months postoperatively, pain and function were significantly improved. Opioid-naive and opioid-experienced patients reduced consumption by 69% and 44%, respectively. Forty-six percent and 26% weaned completely. Consumption at hospital discharge predicted weaning in opio...