[The use of locoregional anesthesia in the prevention of postoperative pain].
Preemptive analgesia is a new concept suggesting that postoperative pain may be attenuated if the transmission of pain is blocked before the occurrence of noxious stimuli. The widespread use of regional anesthesia whether or not associated to general anesthesia has contributed to the improvement of postoperative pain both in ambulatory surgery and inpatients. Numerous studies have demonstrated that postoperative analgesia was better after regional anesthesia when compared to general anesthesia. However, preemptive analgesia means the benefits of an analgesia technique administered before (no after) the occurrence of noxious stimuli. Unfortunately, very few studies have met this principal criteria in their design. Moreover, other criterias are also important in investigating preemptive postoperative analgesia such as: 1) the duration of preemptive analgesia (catheter,...); 2) the importance of surgical stress; 3) the multiple components of postoperative pain; 4) the analgesics used; 5) the route of administration. In conclusion, the participation of regional anesthesia in preventing postoperative pain remains controversial. Numerous studies are needed in the future. These studies should take into account the above criterias and should include a large number of patients in order to find first the type of surgery that could benefit and second, the preemptive analgesia treatment that should be used in such indications.
Narchi
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Clinique Sainte-Croix, Le Mans.
D000765:Anesthesia, Conduction; D000772:Anesthesia, Local; D006801:Humans; D010149:Postoperative Pain / Q000517:prevention & control*
Utilisation de l'anesthésie loco-régionale dans la prévention de la douleur postopératoire.