High-dose opioid prescribing after surgery is a major contributor to the current opioid public health crisis. Clinical hypnosis presents a nonpharmacological adjunct that can reduce the need for escalating opioid doses to manage acute postoperative pain. Participants who received two brief sessions of clinical hypnosis, one before and one after surgery, consumed up to 35% less opioids  during their hospitalization, had less catastrophic thoughts about their pain, and preserved heart rate variability one month after surgery. Creating novel interventions that enable patients to be empowered over their care is critical to improving perioperative care across the country. We are disseminating the results of the trial and have partnered with a knowledge translation expert to make the treatment materials publicly available on our website, https://www.transitionalpainservice.ca. We also plan to spread this work nationally through the creation of a National Transitional Pain Service that will be available to institutions across Canada.

Objectives: This randomized controlled trial examined clinical hypnosis as a strategy to reduce opioid consumption after major oncological surgery. Opioid prescribing is a critical and standard component of acute pain management after surgery. However, high-dose opioid prescribing after surgery is also a contributor to the current opioid public health crisis. Clinical hypnosis presents a nonpharmacological adjunct that can reduce the need for escalating opioid doses to manage acute postoperative pain.

Results: Participants who received two brief sessions of clinical hypnosis, one before and one after surgery, consumed up to 35% less opioids during their hospitalization and had less catastrophic thoughts about their pain. Moreover, this was accompanied by a preservation of high-frequency heart rate variability a month after surgery. These positive findings strengthen support for the utility of clinical hypnosis in the perioperative period and the integration of psychology into the multidisciplinary team.

Conclusion: The demonstrated efficacy of the intervention supports the need and utility of multidisciplinary pain care for individuals undergoing surgery. The brief, manualized intervention employed in the study makes adoption manageable and practical in other institutions and regions.

Challenges Faced: The conclusion of data collection for the project co-incided with the onset of the COVID-19 pandemic. which led to unexpected staffing loss. The primary and secondary analyses are now under review and we have partnered with a knowledge translation expert to make the treatment materials publicly available on our website, www.transitionalpainservice.ca

Next Steps: The Health Canada’s Substance Use and Addictions Program (SUAP) has approached us to build a National Transitional Pain Program which will incorporate a scalable and accessible version of this intervention, making it available to institutions across the country.