Résumé
Au regard de sa définition par l’IASP („une expérience sensorielle et émotionnelle désagréable, associée à des lésions tissulaires réelles ou potentielles, ou décrite en termes de tels dommages“), la douleur ne peut et ne doit pas être considérée comme une simple réponse à un stimulus nociceptif, mais est aussi l’expression conjointe de l’histoire de l’individu et de ses relations avec l’environnement [1], associée aux processus de plasticité que le système nerveux central met en place et utilise pour répondre de façon adaptée aux stimuli nociceptifs. Il a ainsi été montré que la plasticité inhérente au système nerveux central module physiologiquement la transmission de l’information nociceptive [2]. La sensation douloureuse relève alors d’un subtil équilibre entre l’activité de systèmes inhibiteurs (antinociceptifs) et de systèmes facilitateurs (pronociceptifs) de la nociception [3]. L’activation de ces derniers reposerait plus particulièrement sur la mise en jeu de processus de sensibilisation dont on sait aujourd’hui qu’ils sont responsables d’une majoration de la douleur post-opératoire à travers l’expression d’une hyperalgésie.
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Rivat, C., Richebe, P. (2013). Stratégies anti-hyperalgésiques dans la prévention des douleurs chroniques post-chirurgicales : données précliniques et application clinique. In: La douleur chronique post-chirurgicale. Springer, Paris. https://doi.org/10.1007/978-2-8178-0026-4_10
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DOI: https://doi.org/10.1007/978-2-8178-0026-4_10
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