Survey of chronic pain practice by anesthesiologists in Canada

  • Philip W. H. Peng
  • Elkin D. Castano
Regional anesthesia and pain



To describe the pattern of chronic pain practice (CPP) among anesthesiologists in Canada.


Following hospital Ethics Committee approval, a detailed postal questionnaire was sent to all active members of the Canadian Anesthesiologists’ Society. A second mailing was conducted two months later.


The overall response rate was 53%. While 38% of responding anesthesiologists were involved in CPP, in the majority of cases, this accounted for less than 20% of their clinical time. Thirty percent of those involved in CPP had previous training in pain management. The types of CPP included nerve blocks (84%) and pharmacological treatment (60%) in non-cancer pain (85%) and cancer pain (50%) patients. Ten percent and 28% of anesthesiologists were involved in research and teaching respectively while 26% were affiliated with a multidisciplinary clinic. The healthcare professions that anesthesiologists had access to or were directly working with in their practice were as follows: acupuncture (18%), nursing (36%), psychology (28%), psychiatry (35%) and physiotherapy (58%). Epidural steroid injection was the most commonly practiced intervention (82%). This was followed by trigger point injection (70%), stellate ganglion block (61%), occipital nerve block (60%) and lumbar sympathetic block (50%). Practice of interventional procedures was highly diverse.

Seventy percent of anesthesiologists prescribed opioids as part of their CPP. However, half of them never incorporated an opioid agreement with patients. Opioids were most commonly used in the sustained release form.


Approximately one-third of anesthesiologists surveyed incorporate chronic pain in their practice and their pattern of practice is widely diversified.


Décrire le modèle de pratique en douleur chronique (PDC) des anesthésiologistes du Canada.


Avec l’accord du Comité d’éthique, nous avons posté un questionnaire détaillé aux membres actifs de la Société canadienne des anesthésiologistes. Un second envoi a été fait deux mois plus tard.


Le taux de réponse global a été de 53 %. Si 38 % des répondants étaient impliqués dans la PDC, dans la majorité des cas, c’était pour moins de 20 % du temps de clinique. Parmi les personnes en PDC, 30 % avaient reçu une formation en traitement de la douleur.

Les modalités de PDC comprennent les blocs nerveux (84 %) et un traitement pharmacologique (60 %) pour la douleur non cancéreuse (85 %) et cancéreuse (50 %). Dix pour cent et 28 % des anesthésiologistes ont respectivement participé à la recherche et à l’enseignement, et 26 % ont été associés à une clinique multidisciplinaire. Les professions de la santé auxquelles les anesthésiologistes avaient accès ou avec lesquelles ils ont travaillé directement sont : l’acupuncture (18 %), les soins infirmiers (36 %), la psychologie (28 %), la psychiatrie (35 %) et la physiothérapie (58 %).

L’injection péridurale de stéroïde était l’intervention la plus fréquente (82 %). C’était suivi de l’injection dans une zone réflexogène (70 %), du bloc du ganglion stellaire (61 %), du bloc du nerf occipital (60 %) et du bloc lombaire sympathique (50 %). La pratique de procédures interventionnelles était très diversifiée.

Soixante-dix pour cent des anesthésiologistes prescrivaient des opioïdes dans leur PDC. Mais la moitié d’entre eux n’ont jamais intégré d’entente pour opiacés avec leurs patients. Ces médicaments étaient utilisés le plus souvent dans leur formulation à libération lente.


Environ un tiers des anesthésiologistes sondés incluent la douleur chronique dans leur pratique et leur modèle de pratique est largement diversifié.


Chronic Pain Nerve Block Cancer Pain Complex Regional Pain Syndrome Epidural Steroid Injection 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
[Enquête sur la pratique en douleur chronique des anesthésiologistes du Canada]


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Copyright information

© Canadian Anesthesiologists 2005

Authors and Affiliations

  1. 1.Department of Anesthesiology and Pain ManagementUniversity Health Network and Mount Sinai Hospital, Wasser Pain Management Center, Mount Sinai Hospital, University of TorontoTorontoCanada

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