Transitional Pain Service: Optimizing Complex Surgical Patients

Curr Pain Headache Rep. 2024 Mar;28(3):141-147. doi: 10.1007/s11916-023-01204-4. Epub 2023 Dec 20.

Abstract

Purpose of review: The care of patients with complex postsurgical pain can be challenging and burdensome for the healthcare system. Transitional pain service (TPS) is a relatively new concept and has not been widely adopted in the USA. This article explores the benefits and barriers of transitional pain services and describes the development of a TPS at our institution.

Recent findings: Evidence from a few institutions that have adopted TPS has shown decreased postsurgical opioid consumption for patients on chronic opioids and decreased incidence of chronic postsurgical opioid use for opioid-naïve patients. The development of a transitional pain service may improve outcomes for these complex patients by providing longitudinal and multidisciplinary perioperative pain care. In this article, we describe the implementation of a TPS at a tertiary medical center. Our TPS model involves a multidisciplinary team of anesthesiologists, pain psychologists, surgeons, and advanced practice providers. We provide longitudinal care, including preoperative education and optimization; perioperative multimodal analgesic care; and longitudinal follow-up for 90 days post-procedure. With our TPS service, we aim to reduce long-term opioid use and improve functional outcomes for our patients.

Keywords: Acute pain; Opioid-sparing; Postsurgical pain; Transitional pain service.

Publication types

  • Review

MeSH terms

  • Analgesics / therapeutic use
  • Analgesics, Opioid* / therapeutic use
  • Humans
  • Opioid-Related Disorders* / drug therapy
  • Pain, Postoperative / drug therapy
  • Pain, Postoperative / epidemiology
  • Perioperative Care / methods

Substances

  • Analgesics, Opioid
  • Analgesics