Background and Aims The Perioperative Pain Service (POPS) at Hospital for Special Surgery (HSS) is a multidisciplinary team that manages acute and complex pain in orthopedic surgical patients. Under POPS, the chronic/complex pain service (CPS) team has a structured approach to preoperatively identify patients with chronic opioid use, substance use disorder or other complex pain issues, and tailors perioperative pain management plans to optimize outcomes. The aim of this study was to identify overall CPS utilization and case characteristics in a single, high-volume orthopedic specialty hospital.
Methods After IRB approval for a prospective, standard of care POPS registry, surgical cases requiring a CPS consult during hospitalization for orthopedic surgical procedures between January 2022 and May 2023 were identified and service metrics extracted.
Results figure 1). Overall, 1,048 (61%) had an in-person, preoperative pain consultation. Patient-controlled analgesia was administered in 73% of cases; perineural catheters were placed in 23 cases (2%), of which 15 (65%) were after a total knee replacement. Post-discharge POPS consults were required in 1% of CPS cases.
Conclusions CPS manages patients’ post-surgical pain through a multi-pronged approach. While most patients were appropriately identified preoperatively and referred to CPS by the surgical team, there is room for improvement. The low percentage of post-discharge POPS follow-ups reflects appropriate discharge planning with the patients’ surgical, pain and primary care providers.
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