Hyperalgésie postopératoire

Postoperative hyperalgia can be defined as including the different hypersensitivity phenomena observed after surgical procedures which are the clinical expression of neurophysiological phenomena leading to sensitization of the nociception system. The pathophysiology of postoperative hyperalgia is complex and includes peripheral sensitization (local nociception phenomena) and central sensitization (activation of NMDA receptors in the posterior cord). These two phenomena lead to primary and secondary peripheral hyperalgia. Opioids also participate in the development of these hypersensitization phenomena due to their short-acting central hyperalgesic effects. Prevention of postoperative hyperalgia involves limiting tissue damage, use of local anesthetics, and certain antalgic agents such as ketamine. Gabapentine appears to offer promising results with excellent tolerance.