Résumé
Les progrés constants des techniques opératoires et de l'anesthésiologie permettent aujourd'hui d'élargir les indications opératoires à des patients de plus en plus âgés. La chirurgie plastique n'échappe pas à cette importante évolution. Cependant, certaines complications peuvent survenir et générer une souffrance aussi bien somatique que morale. Nous présentons un cas de douleurs neurogènes après un lifting de la face qui illustre cette double problématique, ainsi que les difficultés que l'on peut rencontrer aussi bien à identifier et à évaluer l'origine des douleurs qu'à établir une stratégie thérapeutique globale efficace.
Summary
Current progress in surgical procedures and anaesthesia allow a large use of surgery with old patients, including plastic surgery. However, positive results are not always obtained and some surgical procedures can result in somatic and psychological negative side effects, generating consistent suffering. A case report of neuropathic pain following a facelift is presented, which illustrates the difficulties to identify and to relieve pain and suffering.
Bibliographie
McGregor M.W. and Greenberg R.L.: Rhytidectomy. In: Goldwyn R.M. (ed). The unfavourable results in plastic surgery. (Eds) Little, Brown & Company, Boston, pp. 335–349, 1972.
Kridel R.W.H. and Bressler F.J.: Surgery of the ageing face. Medical Clinics of North America 77, 657–675, 1993.
Boivie J. and Leijon G.: Clinical findings in patients with central post-stroke pain. In: Casey K.L. (Ed.). Pain and central nervous system disease: The central pain syndromes, Raven Press, New-York pp. 65–77, 1991.
Tasker R.L.: Pain resulting in central nervous system pathology (central pain). In: Bonica J.J. (ed.). The management of pain. Volume 1.: Eds, Lea and Febiger, Philadelphia, pp. 264–283, 1990.
Boureau F. Doubrère J.F. and Luu M.: Study of verbal description in neuropathic pain. Pain 42, 145–152, 1990.
Lindblom U. and Hansson P.: Sensory dysfunction and pain after clinical nerve injury studied by means of graded mechanical and thermal stimulation. In: Besson J.M. and Guilbaud G. (Eds), Lesions of primary afferent fibres as a tool for the study of clinical pain, Elsevier, Amsterdam, pp. 1–19, 1991.
Dray A., Urban L. and Dickenson A.H.: Pharmacology of chronic pain. TIPS 16, 99–104, 1993.
Woolf C.J. and Doubell T.P.: The pathophysiology of chronic pain: increased sensitivity to low threshold Ab fibres input. Curr. Opin. Neurobiol. 4, 525–534, 1994.
Willis W.D.: Central plastic response to pain In: Gehbart G.F., Hammond D.L., Jensen T.S. (Eds), Proceedings of the VIIth World Congress on Pain. Progress in pain research and management 12 IASP Press Seattle, pp. 301–324, 1994.
Coderre T.J., Katz J., Vaccarino A.L. and Melzack R.: Contribution of central neuroplasticity to pathological pain: review of clinical and experimental evidence Pain 52, 259–285, 1993.
Dubner R.: Neuronal plasticity and pain following peripheral tissue inflammation and nerve injury. In: Bond M.R., Charlton J.J.E. and Woolf C.J. (Eds), Pain research and clinical management Elsevier, Amsterdam, pp. 243–257, 1991.
Devor M.: Neuropathic pain and injured nerve: Peripheral mechanisms. Brit. Med. Bull. 47, 619–630, 1991.
Wall P.: Neuropathic pain and injured nerve: Central mechanisms. Brit. Med. Bull. 47, 631–643, 1991.
Max M.B., Culnane M., Schafer F.C., Gracely R.H., Walther D.J. et al.: Amitriptilyne relieves diabetic neuropathy pain in patients with normal and depressed mood. Neurology 37, 589–596, 1987.
Max M.B.: Neuropathic pain syndromes. Advances in pain research and therapy. In: Max M., Porternoy R. and Laska P. (Eds), Raven Press, New York, pp. 192–231, 1991.
Kishone-Kumar R., Max M.B., Schafer S.C. et al.: Desipramine relieves pain in post-herpetic neuralgia. Clin. Pharm. Ther. 47, 305–312, 1990.
Max B.M., Kishone-Kumar R., Schafer S.C., Meister B., Gracel R.H., Smoller B. and Dubner R.: Efficacy of desipramine in painful diabetic neuropathy: a placebo-controlled trial. Pain 45, 3–9, 1991.
Kishone-Kumar r., Schafer S.C., Lowlar B.A., Murphy D.L. and Max M.B. Single dose of serotonin agoinsts buspiron and m-chlorphenylpiperain do not relieve neuropathic pain. Pain 37, 223–227, 1989.
Swerdlow M.: Anticonvulsivant drugs and chronic pain. Clin. Neuropharmacol. 7, 51–82, 1984.
Rowbotham M.C., Reisner-Keller L.A and Fields H.L.: Both intravenous lidocaine and morphine reduce the pain of postherpetic neuralgia. Neurology 41, 1024–1028, 1991.
Author information
Authors and Affiliations
About this article
Cite this article
Arroyo, J.F., Desmeules, J.A. Douleurs neurogènes après lifting de la face et du cou chez une patiente âgée. Doul. et Analg. 9, 55–59 (1996). https://doi.org/10.1007/BF03003127
Issue Date:
DOI: https://doi.org/10.1007/BF03003127