Prevention of Chronic Postsurgical Pain in Chronic Opioid Users:

Condition(s) studied

Investigational drug(s) / intervention(s)

standard institutional perioperative management: standard institutional perioperative management

specialized teleconsultation: Patients in the intervention arm participate in a specialized teleconsultation between postoperative day 15-28 to detect poorly controlled pain, neuropathic features, or opioid-related concerns, and to adjust treatment if needed.

Study summary

Chronic opioid users undergoing surgery are at increased risk of CPSP, contributing to long-term disability, decreased quality of life, and prolonged opioid exposure. Existing preventive strategies remain limited, and early postoperative monitoring may represent a key opportunity for intervention. Evidence suggests that transitional pain services can improve outcomes by optimizing pain control and reducing long-term opioid consumption, but implementation is heterogeneous and often resource-intensive. Telemedicine offers a scalable alternative, enabling early specialized evaluation and timely therapeutic adjustments while maintaining accessibility. This randomized controlled trial will compare standard postoperative follow-up with standard follow-up plus a specialized teleconsultation performed between postoperative day 15 and 28. The intervention aims to detect insufficiently controlled pain, signs of neuropathic pain, or maladaptive opioid use, and to propose individualized therapeutic adjustments when required.

Participants will be followed for 6 months. Primary assessment will occur at 3 months to determine CPSP incidence. Secondary assessments will include pain trajectory (intensity, neuropathic features, functional interference), opioid consumption and misuse, quality of life, and a descriptive medico- economic evaluation

Eligibility

Primary outcome measure(s)

• Incidence of chronic postsurgical pain (CPSP) — at 3 months
  Incidence of chronic postsurgical pain (CPSP) at 3 months, defined as: * new or aggravated postsurgical pain located at the surgical site or innervated territory, * persistent for ≥3 months, * intensity ≥3/10 (new pain) or increase ≥2/10 from baseline (aggravation), * with significant functional impact (≥3/10 on at least one Brief Pain Inventory interference item), * assessed at day 90 ±14.

Trial sites (1)

More Centre Hospitalier Universitaire, Amiens trials in France

Other trials for the same condition