Résumé
Il ne fait plus de doute aujourd’hui qu’une fraction importante des douleurs chroniques post-chirurgicales (DCPC) sont de nature neuropathique, bien que toute lésion nerveuse, y compris chirurgicale, ne soit pas systématiquement suivie d’une complication douloureuse à long terme [1]. Si une lésion nerveuse est nécessaire mais non suffisante au développement d’une douleur neuropathique post-chirurgicale (DNPC), les mécanismes sous-tendant l’initiation et le maintien de la douleur après chirurgie restent mal connus, en partie parce qu’ils ont été peu étudiés et parce que la physiopathologie n’en est pas forcément univoque. En effet, la coexistence de mécanismes inflammatoires et de facteurs psychologiques est à prendre en compte lorsqu’une lésion nerveuse provoquée par un acte chirurgical, agression par nature aiguë, aboutit à une douleur neuropathique chronique séquellaire. Depuis quelques années, divers modèles cliniques ont retenu l’attention des investigateurs, en particulier de deux équipes françaises et d’une équipe danoise discutant prévalence, mécanismes et facteurs de risque de DNPC, et fournissant des données cliniques précises et d’évaluation semi-quantitative de la sensibilité après herniorraphie, thoracotomie, ou prélèvement de greffon iliaque.
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Mick, G., Guastella, V., Dualé, C., Martinez, V. (2013). Douleur neuropathique post-chirurgicale. In: La douleur chronique post-chirurgicale. Springer, Paris. https://doi.org/10.1007/978-2-8178-0026-4_12
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DOI: https://doi.org/10.1007/978-2-8178-0026-4_12
Publisher Name: Springer, Paris
Print ISBN: 978-2-8178-0025-7
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