[Nociceptive modulation during intravenous anesthesia].
The surgical stress can be defined as a complex array of neuroendocrine, haemodynamic, metabolic and inflammatory changes following surgical injury. These responses, when excessive, may contribute to increased postoperative morbidity and mortality. Thus a major endpoint of general anaesthesia is to protect the patient against the noxious stress response components. The different classes of anaesthetic or associated drugs are reviewed in this respect: sedative/hypnotics (barbiturates, etomidate, propofol, benzodiazepines), opioids, alpha-2 adrenergic agonists (clonidine), non-steroidal antiinflammatory drugs, intravenous local anaesthetics. Central and peripheral sensitization phenomenons--ie the sympathoadrenal response to surgery--might likely be efficiently attenuated by preemptive analgesia, and/or well-designed computer-guided total intravenous anaesthesia. 119 references complete this review.
Vandermeulen
E P
EP
Department of Anesthesia and Pain Management, University of Texas, Southwestern Medical Center at Dallas 75235-9068.
White
P F
PF
D000319:Adrenergic beta-Antagonists / Q000494:pharmacology; D000771:Anesthesia, Intravenous; D000777:Anesthetics / Q000494:pharmacology*; D000779:Anesthetics, Local / Q000494:pharmacology; D005045:Etomidate / Q000494:pharmacology; D006801:Humans; D006993:Hypnotics and Sedatives / Q000494:pharmacology; D009294:Narcotics / Q000494:pharmacology; D010147:Pain Measurement / Q000187:drug effects*; D013312:Stress, Physiological / Q000503:physiopathology*
D000319:Adrenergic beta-Antagonists; D000777:Anesthetics; D000779:Anesthetics, Local; D006993:Hypnotics and Sedatives; D009294:Narcotics; D005045:Etomidate
Modulation nociceptive au cours de l'anesthésie intraveineuse.