Acute Pain after Thoracic Surgery Predicts Long-Term Post-Thoracotomy Pain

Perioperative medicine: why do we care?

“…[16][17][18][19] In this regard, readers are encouraged to read the excellent review by Gilron and Kehlet. 20 Chronic post-surgical pain is a complex subject, but anesthesiologists have an undisputed role in the prevention of chronic pain after surgery.…”

“…[16][17][18][19] À ce propos, les lecteurs sont vivement encouragés à lire l'excellente synthèse de Gilron et Kehlet. 20 La douleur chronique postopératoire est un sujet complexe, mais les anesthésiologistes ont un rôle incontestable à jouer dans sa prévention.…”

Effects of sevoflurane on carrageenan- and fentanyl-induced pain hypersensitivity in Sprague-Dawley rats

“…13 During the last decade, many intraoperative antihyperalgesic strategies were designed to oppose the development of central sensitization that leads to exaggerated acute postoperative pain and chronic pain. [14][15][16][17] Interestingly, the administration of low doses of pharmacological agents with NMDA receptor antagonistic properties, such as ketamine and nitrous oxide, reduced hyperalgesia, even though these drugs did not elicit analgesic effects per se. 8,[18][19][20] These results were described on nociceptive-induced hyperalgesia (inflammation or surgery), high doses of fentanyl-induced hyperalgesia, and a combination of both.…”

L’analgésie préventive expérimentale, quelle est sa valeur clinique?

“…It has been demonstrated that early postoperative pain is a significant predictor of long-term pain. 9 It was hoped that steps which would reduce or abolish noxious input to the spinal cord during surgery would reduce or minimize spinal cord changes and thereby lead to reduced pain postoperatively and in the long term. It would be expected that an intervention which pre-empts central sensitization and seeks to prevent it from occurring, rather than attempts to treat it after it has occurred, would be more successful.…”

“…On sait que la douleur postopératoire précoce constitue un prédicteur significatif de la douleur prolongée. 9 Aussi espérait-on que les mesures prises pour atténuer ou abolir la transmission peropératoire du stimulus nociceptif vers la moelle allaient diminuer les changements médullaires et, ainsi, réduire la douleur postopératoire et la douleur prolongée. On pensait donc réussir en empêchant la sensibilisation centrale et en cherchant à la prévenir plutôt qu'à la traiter après coup.…”