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Utilisation des analgésiques dans l’insuffisance hépatique

Use of analgesics in patients with hepatic impairment

  • Article de Synthèse / Review Article
  • Published:
Douleur et Analgésie

Résumé

Les changements physiologiques survenant lors d’une insuffisance hépatique peuvent altérer la disposition de nombreux médicaments y compris les analgésiques. De plus, la survenue de complications, telles que les irritations gastro-intestinales ou l’atteinte de la fonction rénale en cas de prise d’un anti-inflammatoire non stéroïdien (AINS), ou la sensibilité aux effets indésirables centraux suite à la prise d’un opioïde, est accrue dans cette population. Cette revue a pour but d’évaluer la possibilité d’utilisation des analgésiques chez l’insuffisant hépatique et de guider le prescripteur dans le choix du traitement de la douleur adapté à cette population.

Abstract

The physiologic changes that accompany hepatic impairment alter the disposition of many drugs, analgesics included. Furthermore, complications such as gastrointestinal irritation and renal failure following NSAIDs use or increased sensitivity to the central opioid effects are more likely to occur in patients with hepatic impairment. The aim of this review is to evaluate the use of analgesics and guide the physicians in their choice of pain treatment for patients with hepatic impairment.

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Authors and Affiliations

  1. Service de pharmacologie et toxicologie cliniques, hôpitaux universitaires de Genève, rue Gabrielle Perret-Gentil 4, 1211, Geneva, Suisse

    M. Bosilkovska, Y. Daali & J. Desmeules

  2. Service d’anesthésiologie, hôpitaux universitaires de Genève, rue Gabrielle Perret-Gentil 4, 1211, Geneva, Suisse

    B. Walder

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  1. M. Bosilkovska
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  2. Y. Daali
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  3. B. Walder
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  4. J. Desmeules
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Correspondence to J. Desmeules.

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Bosilkovska, M., Daali, Y., Walder, B. et al. Utilisation des analgésiques dans l’insuffisance hépatique. Douleur analg 26, 209–217 (2013). https://doi.org/10.1007/s11724-013-0359-3

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  • DOI: https://doi.org/10.1007/s11724-013-0359-3

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