The neurophysiologic concept of neuroplasticity represents one of the current basis of the pathophysiology of painful post-injury phenomenons (postoperative, post-traumatic...). Deriving directly from these experimental data, the idea of preemptive analgesia has gradually developed in the last five years, the central question being to know if an analgesic intervention preceding surgical intervention is more efficient, as efficient, or less efficient than the same intervention following surgery. The authors bring current data of the literature in favor of the role of neuroplasticity in the genesis and the persistence of painful states in the course of postoperative outcome. A review of the various clinical studies and controversies published is proposed, in the attempt to make the point on current therapeutic implications of the concept of preemptive analgesia.