Please confirm that an ethics committee approval has been applied for or granted: Yes: I’m uploading the Ethics Committee Approval as a PDF file with this abstract submission

Background and Aims The prolonged use of opioid medications postoperatively can lead to physiological, psychological, and even social issues for patients. Some scholars have suggested that gaps in postoperative pain management may contribute to the development of persistent postsurgical pain. However, it remains unknown whether early intervention by pain physicians postoperatively may lead to long-term opioid use issues.

Methods This retrospective cohort study utilized the Longitudinal Health Insurance Research Database of Taiwan from 2001 to 2018. Among 506,092 patients who underwent surgery and anesthesia, 277,658 were included in the final analysis after excluding those with missing data, obstetric or congenital surgical procedures, death or rehospitalization within 3 months post-surgery, and emergency surgeries within 3 months post-surgery. Among them, 33,984 received outpatient care from pain specialists within 90 days post-surgery, while 243,674 did not.

Results In both groups, the risk of long-term opioid use post-surgery was 1.716 (1.661-1.774), P < 0.0001. The risk of mortality within 3-12 months post-surgery was 0.793 (0.711-0.883), P < 0.0001. The risk of rehospitalization within 3-6 months post-surgery was 1.534 (1.469-1.603), P < 0.0001.

Conclusions According to data from the Taiwan Pain Society, rehabilitation physician and anesthesiologist are the primary physicians involved in pain management in Taiwan. However, the majority of patients receiving rehabilitation care after orthopedic surgery, which is a risk factor for long-term opioid use, may contribute to the seemingly higher risk of long-term opioid use among patients receiving pain management. Further statistical analysis is needed to clarify this aspect.