Skip to main content
SpringerLink
Log in

Stratégie péri-opératoire de prévention des douleurs chroniques post-chirurgicales : bases générales

  • Chapter
La douleur chronique post-chirurgicale

  • 722 Accesses

Résumé

La survenue de douleurs chroniques après chirurgie (DCPC) est un phénomène maintenant reconnu dont la réalité et l’ampleur ont été mises en évidence par de nombreuses études épidémiologiques. La persistance des douleurs après chirurgie reconnaît un certain nombre de facteurs de risque parmi lesquels certains tiennent aux patients eux-mêmes, d’autres au type de chirurgie pratiquée. L’anesthésie a pour rℓe la prévention des phénomènes adverses liés à la chirurgie. Elle exerce cette fonction durant l’acte opératoire. Cependant, si l’on considère le problème des DCPC, il apparaît possible que l’anesthésie joue un rℓe préventif mais dans certaines circonstances un rℓe facilitateur. En effet, l’altération de la réponse physiologique à la douleur avec le développement des phénomènes d’hyperalgésie et d’allodynie, que traduit une exacerbation de la sensation douloureuse, fait partie des mécanismes susceptibles de faciliter la survenue de DCPC [1]. Il semble exister une relation entre la surface de l’allodynie mécanique péri-cicatricielle post-opératoire immédiate et l’incidence de la DCPC: plus la surface est grande, plus le risque de douleur chronique est élevé [2]. La réduction ou la prévention des phénomènes d’allodynie et d’hyperalgésie pourraient donc avoir comme finalité la prévention de la DCPC.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Références

  1. Rivat C, Laboureyras E, Laulin JP, et al. (2007) Non-nociceptive environmental stress induces hyperalgesia, not analgesia, in pain and opioid-experienced rats. Neuropsychopharmacology 14: 14

    Google Scholar 

  2. Eisenach JE (2006) Preventing chronic pain after surgery: who, how, and when? Reg Anesth Pain Med 31: 1–3

    PubMed  Google Scholar 

  3. Célèrier E, Rivat C, Jun Y, et al. (2000) Long-lasting hyperalgesia induced by fentanyl in rats: preventive effect of ketamine. Anesthesiology 92: 465–72

    Article  PubMed  Google Scholar 

  4. Laulin JP, Maurette P, Corcuff JB, et al. (2002) The role of ketamine in preventing fentanyl-induced hyperalgesia and subsequent acute morphine tolerance. Anesth Analg 94: 1263–9

    Article  PubMed  CAS  Google Scholar 

  5. Rivat C, Laulin JP, Corcuff JB, et al. (2002) Fentanyl enhancement of carrageenan-induced long-lasting hyperalgesia in rats: prevention by the N-methyl-d-aspartate receptor antagonist ketamine. Anesthesiology 96: 381–91

    Article  PubMed  CAS  Google Scholar 

  6. Richebe P, Rivat C, Laulin JP, et al. (2005) Ketamine improves the management of exaggerated postoperative pain observed in perioperative fentanyl-treated rats. Anesthesiology 102: 421–8

    Article  PubMed  CAS  Google Scholar 

  7. Laboureyras E, Chateauraynaud J, Richebe P, Simonnet G (2009) Long-term pain vulnerability after surgery in rats: prevention by nefopam, an analgesic with antihyperalgesic properties. Anesth Analg 109: 623–31

    Article  PubMed  CAS  Google Scholar 

  8. Guignard B, Bossard AE, Coste C, et al. (2000) Acute opioid tolerance: intraoperative remifentanil increases postoperative pain and morphine requirement. Anesthesiology 93: 409–17

    Article  PubMed  CAS  Google Scholar 

  9. Elia N, Tramèr MR (2005) Ketamine and postoperative pain: a quantitative systemic review of randomized trials. Pain 113: 61–70

    Article  PubMed  CAS  Google Scholar 

  10. Bell RF, Dahl JB, Moore RA, Kalso E (2006) Perioperative ketamine for acute postoperative pain (review). The Cochrane Collaboration: CD 004603

    Google Scholar 

  11. Joly V, Richebe P, Guignard B, et al. (2005) Remifentanil-induced postoperative hyperalgesia and its prevention with small-dose ketamine. Anesthesiology 103: 147–55

    Article  PubMed  CAS  Google Scholar 

  12. Stubhaug A, Breivik H, Eide PK, et al. (1997) Mapping of punctuate hyperalgesia around a surgical incision demonstrates that ketamine is a powerful suppressor of central sensitization to pain following surgery. Acta Anaesthesiol Scand 41: 1124–32

    Article  PubMed  CAS  Google Scholar 

  13. Suzuki M, Haraguti S, Sugimoto K, et al. (2006) Low dose intravenous ketamine potentiates epidural analgesia after thoracotomy. Anesthesiology 105: 111–9

    Article  PubMed  CAS  Google Scholar 

  14. De Kock M, Lavand’homme P, Waterloos H (2001) Balanced analgesia in the perioperative period: is there a place for ketamine? Pain 2001; 92: 373–80

    Article  PubMed  Google Scholar 

  15. Rémérand F, Le Tendre C, Baud A, et al. (2008) The eraly and delayed analgesic effects of ketamine after total hip arthroplasty: a prospective randomized controlled double-blind study. Anesth Analg 109: 1963–71

    Article  Google Scholar 

  16. Crouzier M, Cognet V, Khaled M, et al. (2008) Effets de la kétamine dans la prévention des douleurs chroniques post-mastectomies. Étude pilote. Ann Fr Anesth Réanim 27: 987–93

    Article  Google Scholar 

  17. Dualé C, Sibaud F, Guastella V, et al. (2009) Perioperative ketamine does not prevent chronic pain after thoracotomy. Eur J Pain 13: 495–505

    Article  Google Scholar 

  18. Van Elstraete AC, Sitbon P, Mazoit JX, Benhamou D (2008) Gabapentin prevents delayed and long-lasting hyperalgesia induced by fentanyl in rats. Anesthesiology 108: 484–94

    Article  PubMed  Google Scholar 

  19. Tiippana EM, Hamunen K, Kontinen VK, Kalso E (2007) Do surgical patients benefit from perioperative gabapentin/pregabalin? A systematic review of efficacy and safety. Anesth Analg 104: 1545–56

    Article  PubMed  CAS  Google Scholar 

  20. Mathiesen O, Moiniche S, Dahl JB (2007) Gabapentin and postoperative pain; a qualitative and quantitative systematic review, with focus on procedure. BMC Anesthesiology 7: 6

    Article  PubMed  Google Scholar 

  21. Fassoulaki A, Triga A, Melmeni A, et al. (2005) Multimodal analgesia with gabapentin and local anesthetics prevents acute and chronic pain after breast surgery for cancer. Anesth Analg 101: 1427–32

    Article  PubMed  CAS  Google Scholar 

  22. Fassoulaki A, Stamatakis G, Sisafaka I, et al. (2006) Gabapentin attenuates late but not acute pain after abdominal hysterectoly. Eur J Anaesth 23: 136–41

    Article  CAS  Google Scholar 

  23. Brogly N, Wattier JM, Andrieu G, et al. (2008) Gabapentin attenuates late but not early postoperative pain after thyroidectomy with superficial cervical block. Anesth Analg 107: 1720–5

    Article  PubMed  CAS  Google Scholar 

  24. Clarke H, Pereira S, Kennedy D, et al. (2009) Adding gabapentin to a multimodal regimen does not reduce acute pain, opioid consumption or chronic pain after total hip arthroplasty. Acta Anaesthesiol Scand 53: 1073–83

    Article  PubMed  CAS  Google Scholar 

  25. Sen H, Sizlan A, Yanarates O, et al. (2009) A comparison of gabapentin and ketamine in acute and chronic pain after hysterectomy. Anesth Analg 109: 1645–50

    Article  PubMed  CAS  Google Scholar 

  26. Novelli A, Diaz-Trelles R, Groppetti A, Fernandez-Sanchez MT (2005) Nefopam inhibits calcium influx, cGMP formation, and NMDA receptor-dependent neurotoxicity following activation of voltage sensitive calcium channels. Amino Acids 28: 183–91

    Article  PubMed  CAS  Google Scholar 

  27. Tirault M, Derrode N, Clevenot D, et al. (2006) The effect of nefopam on morphine overconsumption induced by large-dose remifentanil during propofol anesthesia for major abdominal surgery. Anesth Analg 102: 110–7

    Article  PubMed  CAS  Google Scholar 

  28. Picard W, Richebé P, Pouquet O, et al. (2008) Le néfopam réduit l’hyperalgésie postopératoire après chirurgie cardiaque. SFAR 2008, Paris. R212.

    Google Scholar 

  29. Delage N, Maaliki H, Beloeil H, et al. (2005) Median effective dose (ED50) of nefopam and ketoprofen in postoperative patients: a study of interaction using sequential analysis and isobolographic analysis. Anesthesiology 102: 1211–6

    Article  PubMed  CAS  Google Scholar 

  30. Sentürk M, Özcan PE, Talu GK, et al. (2002) The effects of three different analgesia techniques on long-term post-thoracotomy pain. Anesth Analg 94: 11–5

    Article  PubMed  Google Scholar 

  31. Ochroch EA, Gottschalk A, Augostides J, et al. (2002) Long-term pain activity during recovery from major thoracotomy using thoracic epidural analgesia. Anesthesiology 97: 1234–44

    Article  PubMed  Google Scholar 

  32. Ho SC, Royse CF, Royse AG, et al. (2002) Persistent pain after cardiac surgery: An audit of high thoracic epidural and primary opioid analgesia therapies. Anesth Analg 95: 820–3

    PubMed  CAS  Google Scholar 

  33. Lavand’homme P, De Koch M, Waterloos H (2005) Intraoperative epidural analgesia combined with ketamine provides effective preventive analgesia in patients undergoing digestive surgery. Anesthesiology 103: 813–20

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Service d’anesthésie-réanimation, Assistance publique - Hôpitaux de Paris, Université Pierre et Marie Curie, Hôpital Tenon, 4, rue de la Chine, 75020, Paris, France

    F. Bonnet, J. Berger & Y. Ynineb

Authors
  1. F. Bonnet
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J. Berger
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Y. Ynineb
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer-Verlag Paris

About this chapter

Cite this chapter

Bonnet, F., Berger, J., Ynineb, Y. (2013). Stratégie péri-opératoire de prévention des douleurs chroniques post-chirurgicales : bases générales. In: La douleur chronique post-chirurgicale. Springer, Paris. https://doi.org/10.1007/978-2-8178-0026-4_9

Download citation

  • DOI: https://doi.org/10.1007/978-2-8178-0026-4_9

  • Publisher Name: Springer, Paris

  • Print ISBN: 978-2-8178-0025-7

  • Online ISBN: 978-2-8178-0026-4

Publish with us

Policies and ethics

Search

Navigation