Experimental and clinical studies about the preemptive analgesia with local anesthetics. Possible reasons of the failure.

摘要: Though we fully agree with the truthfulness of physiopathological sequences proving phenomena hyperalgesia onset and therefore a prolongation postoperative pain, do not believe, as stated by some authors that studies carried out up to now, both experimental clinical, are sufficient, first ones confirm preemptive analgesia, while second be defined contrasting totally inadequate analgesia effect. The lack positive clinical data is why have suggested "revision" "reduction" word analgesia. On contrary, believe differences which seem originate from works can also found in if examine them same methodological principle. In order classify better such an important treatment like aim this note focus attention on data. Our criterion select has based backwards research taking into consideration last reviews about Since results obtained local anesthetics or opioids counterbalance each other, reexamined limiting our anesthetics. total 19 assessments 16 studies, only three eight comparing pre-vs post-administration prove real effect anesthetic (block phase hyperexcitability) whereas four eleven examined validity These show how equal ones. However, characteristic seems come these connected two elements strictly linked other: intensity duration nociceptive impulse produced level type induced block. opinion, failure many attributed inadequacy analgesic levels (intensity block) reached maintained pre-and intraoperative period. Therefore before thinking "review" necessary take step backward face again problems