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

Opioids revisited: from analgesia to hyperalgesia

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.

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.

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Correspondence to G. Simonnet.

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Simonnet, G., Laboureyras, E. Les opioïdes: de l’analgésie à l’hyperalgésie. Des dogmes à réexaminer ?. Douleur analg 22, 216–228 (2009). https://doi.org/10.1007/s11724-009-0147-2

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Mots clés

  • Opioïdes
  • Analgésie
  • Hyperalgésie
  • Tolérance
  • Douleurs chroniques

Keywords

  • Opioids
  • Analgesia
  • Hyperalgesia
  • Tolerance
  • Chronic pain