Different Mechanisms of Development and Maintenance of Experimental Incision-induced Hyperalgesia in Human Skin

Abstract

Pretraumatic injection of lidocaine reduces primary hyperalgesia more effectively than does posttraumatic injection, but only for a short period after incision. The spread of secondary hyperalgesia is mediated peripheral nerve fibers, but when secondary hyperalgesia has fully developed, it becomes less dependent on or even independent of peripheral neural activity originating from the injured site.

Modality-specific Somatosensory Changes in a Human Surrogate Model of Postoperative Pain

“…In an area surrounding the site of incision we found increased pain to pinprick stimuli (secondary mechanical hyperalgesia), which confirms previous reports after incision in humans 23,24 and after other types of actual or simulated tissue injuries in volunteers. 16,28 -32 Hyperalgesia secondary to mechanical stimuli is considered the perceptual correlate of central sensitization in humans.…”

“…[23][24][25] As shown recently 26,27 spontaneous activity in sensitized C-and A␦-fiber nociceptive afferents induced by deep-tissue (muscle and/or fascia) injury has been suggested as a major contributor to nonevoked ongoing pain after incision in rats. However, the different role of cutaneous and muscle tissue injury to spontaneous pain after incision was not addressed here.…”

“…The apparent biphasicity within the first hour has not yet been described in models of incisional pain, maybe because ongoing pain has not yet been investigated in this temporal resolution. [23][24][25] However, because the reincrease did not reach statistical significance further studies with larger groups of subjects have to address this issue in future studies.…”

Pre- and intraoperative epidural ropivacaine have no early preemptive analgesic effect in major gynecological tumour surgery

“…In spite of contradictory results of studies concerning preemptive analgesia and the lack of effects in the meta-analysis by Moiniche, the concept of preemptive analgesia still remains a topic of intense discussions. 13,16,17 Further investigations with respect to mechanisms of development and treatment strategies are required.…”

Analgésie postopératoire par infiltration continue cicatricielle : pour qui et comment ?

“…Or, il est démontré que les AL ont un effet inhibiteur sur l'inflammation locale engendrée par l'acte chirurgical, ce qui contribue à leur effet anti-hyperalgésique. La diminution des médiateurs de l'inflammation par les AL est attestée par de nombreux travaux [4,5] ce qui engendre un effet bénéfique préventif dans la survenue de douleur chronique postopéra-toire. La mise en place d'un cathéter permet ainsi l'administration prolongée d'anesthésiques et d'augmenter la durée du blocage analgésique et des effets anti-inflammatoires.…”