Douleur et Analgésie

, Volume 22, Issue 4, pp 216–228

Les opioïdes: de l’analgésie à l’hyperalgésie. Des dogmes à réexaminer ?

Revue de la Littérature / Literature Review

Résumé

Bien que les substances opioïdes soient les analgésiques de référence pour prendre en charge les douleurs sévères, un certain nombre d’études expérimentales et cliniques indique qu’ils peuvent induire hyperalgésies et allodynies après l’effet analgésique et même faciliter le passage de la douleur aiguë à la douleur chronique. De nouvelles stratégies thérapeutiques que l’on peut qualifier d’antisensibilisation ou d’antihyperalgésie permettent d’améliorer l’efficacité des antalgiques opioïdes.

Mots clés

Opioïdes Analgésie Hyperalgésie Tolérance Douleurs chroniques 

Opioids revisited: from analgesia to hyperalgesia

Abstract

Although opioids are unsurpassed analgesics, experimental and clinical studies show that opioid therapy designed to alleviate moderate to severe pain may unexpectedly render patients more sensitive to nociception (pain vulnerability) leading to hyperalgesia and allodynia and may facilitate the transition from acute to chronic pain. New therapeutic strategies referred to as antihypersensitivity or antihyperalgesic strategies have to be developed for improving the opioid use in patients.

Keywords

Opioids Analgesia Hyperalgesia Tolerance Chronic pain 

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Copyright information

© Médecine et Hygiène et Springer-Verlag France 2009

Authors and Affiliations

  1. 1.Équipe « Homéostasie-allostasie-pathologie-réhabilitation »université Bordeaux-2BordeauxFrance
  2. 2.CNRS UMR 5227Bordeaux-IIFrance

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