The transitional pain service: a narrative review on the approach to managing chronic post-surgical pain

J Anesth. 2026 Feb 5. doi: 10.1007/s00540-025-03649-w. Online ahead of print.

ABSTRACT

We conducted a narrative review of the Transitional Pain Service (TPS) to (1) synthesize current evidence on its effectiveness and (2) identify key prerequisites for future TPS implementation. Chronic post-surgical pain (CPSP) is a significant and potentially preventable postoperative complication following major surgery. Established at Toronto General Hospital in 2014, the TPS represents a novel multidisciplinary model designed to mitigate CPSP risk and reduce opioid dependence. A comprehensive search of OVID Medline, supplemented by manual hand-searching, was performed using terms related to transitional pain, postoperative pain management, opioids, and chronic pain. Searches were restricted to English language human studies published from 2014 onward. Fourteen articles met inclusion criteria.

Across the literature, TPS interventions consistently demonstrated reductions in postoperative pain and opioid consumption, along with improvements in functional and psychological outcomes. The TPS provides an essential multimodal approach to postoperative care, supporting long-term reductions in opioid use and chronic pain burden. Key prerequisites are proposed to guide successful implementation in future clinical settings.

PMID:41642307 | DOI:10.1007/s00540-025-03649-w