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Physiologie de la douleur Export

EMC - Anesthesie-Reanimation, Vol. 1, No. 4. (October 2004), pp. 227-266.

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anesthesie douleur emc physiologie

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ResumeDepuis 1993, date de notre derniere revue sur la physiologie de la douleur, les connaissances ont particulierement evolue, notamment dans le domaine des mecanismes peripheriques elementaires, qu'il s'agisse de nouveaux peptides, des recepteurs ou de facteurs neurotrophiques impliques dans les phenomenes inflammatoires. Cette > de la physiologie de la douleur n'est donc pas une simple reecriture de l'ancienne version mais une tentative de synthese organisee de ces nouvelles acquisitions. Dans la premiere et principale partie de cet expose, nous nous limiterons au cadre purement physiologique de la douleur aigue (douleur-nociception). Celle qui est utile a la protection de l'organisme. Dans un second temps, nous aborderons, sous l'angle des mecanismes physiopathologiques, quelques dereglements de ces systemes, soit dans le sens des syndromes douloureux chroniques, soit a l'inverse, dans le sens des syndromes d'analgesie.AbstractSince the last review we performed on the physiology of pain and nociception in 1993, the general knowledge on pain has considerably increased, particularly concerning the peripheral mechanisms: new neuropeptides, receptors, specific ionic channels or neurotrophic factors involved in the inflammatory process. The current review of the physiology of pain is an attempt to summarize these new data into comprehensive and organized chapters. In the first and main section (chapters 1 to 6), we expose the classical and updated findings on the physiological pain (acute pain or nociception) which is necessary to the protective reactions of the body. In the second section (chapters 7 and 8), we explain the pathophysiological aspects of some chronic pain syndromes and conversely, of some syndromes in which the sensation of pain is lacking, such as congenital insensitivity to pain.


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