Transitional Pain Service for patients at Risk of chronic postsurgical pain Undergoing Surgery

Recruitment & Eligibility

Status: Pending

Sex: Not specified

Target Recruitment: 180

Inclusion Criteria

Patients aged 18 years or older
2.Willing and able to provide informed consent
3.Undergoing a surgical procedure with an increased risk of CPSP (amputation, spinal surgery, thoracotomy, breast surgery, herniotomy, hysterectomy and after arthroplasty) (9).

Or;

Any surgical procedure and one of the following:
-Diagnosed chronic pain, defined according to the ICD-11 as an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage. Chronic pain is pain that persists or recurs for longer than 3 months (3)”
-Chronic opioid use, defined as > 20 mg daily morphine equivalent (MME) consumption for more than 3 months in the last 3 months
-Allergy to opioid agents
-Patients with pain device implants, such as intrathecal pain pump, spinal cord stimulation or peripheral nerve stimulator
-The usage of pain medication as methadone, buprenorphine, anticonvulsants, antidepressants or medicinal cannabis for chronic pain for more than 3 months in the last three months
Psychosocial comorbidities like anxiety, depression, pain catastrophizing if documented in the electronic medical record

Exclusion Criteria

- Not willing or able to provide written informed consent
- Emergency surgery

Study & Design

Study Type: Interventional

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
The primary outcome is the between group difference in Quality of Recovery (QoR)-15 questionnaire score at day three after surgery.

Secondary Outcome Measures

Name	Time	Method
-Postsurgical chronic pain (CPSP) at three and six months after surgery, defined according to the IASP (as mentioned in chapter 1), and/or taking pain medication to treat CPSP as described above. <br>-Opioid consumption per day, calculated as morphine equivalent dose (MEDs) at day three after surgery, prescription at discharge, and at three and six months after discharge.<br>-Patient-reported outcome as measured by the WHODAS 2.0 (15), PROMIS-29 (16) and EQ-5D-5L (17) preoperatively and at three and six months after discharge.