Project 467176

Chronic post-surgical pain (CPSP), which is pain that persists two months after surgery without a known cause, is a reality for up to 50% of patients who undergo cardiothoracic surgery. For patients experiencing CPSP, opioids are prescribed to ease the pain while waiting to meet a specialist in pain management. For standard referrals, patients often wait for up to nine months, resulting in elevated rates of opioid dependency. In contrast, patients in hospitals with internal pain clinics available for referral have an average wait time of three months for an appointment for pain management. This study attempts to extrapolate how the time gap between the start of opioid use and the meeting with a pain specialist to explore alternative options relates to the proportion of patients dependent on opioid use up to two years after cardiothoracic surgery. It is hypothesized that a positive relationship will be seen with the length of time gap and the proportion of patients with opioid dependency. Retrospective data on patients who underwent cardiothoracic surgery in multiple hospitals will be collected and classified into with or without CPSP. The data to be extracted will include demographic data; time gap, defined by the time between identification of CPSP to the first meeting of the pain specialist if the referral was made; and opioid use, measured by the amount of regular opioid consumption at distinct time points up to two years from the surgical date. These data will be analyzed to determine if any relationships exist between the time gap and opioid dependence. Should the hypothesis stand, then a focus on implementing internal access to pain management options may be applied to decrease the prevalence of opioid dependence in patients with CPSP after cardiothoracic surgery.