Le dialogue de La surprise de l’amour entre dissensus et consensus

Dans une perspective de « rhétorique interactionnelle » et de « dialectique éristique » aux frontières confondues, cette recherche se propose d’examiner un cas constitué par le dialogue des personnages de La surprise de l’amour de Marivaux, le but étant de tenter de voir dans quelle mesure la notion de polémicité — qui se traduit le plus souvent en termes d’agressivité, de violence et de passions — peut s’étendre au champ littéraire et constituer un outil de travail ou d’analyse probant. Autrement dit, si l’on s’éloigne de la littérature de combat et des discours épidictiques de blâme dont la visée suprême est de réduire l’autre au silence en le disqualifiant ou en le convertissant, comment peut-on pertinemment utiliser la notion de polémique dans un contexte et dans des « entretiens » qui auraient dû être normalement régis par la galanterie, la politesse et la civilité?In a perspective of interactional rhetoric and eristic dialectic within confounded frontiers, this research suggests an examination of a case of constituted dialogue of the characters in La surprise de l’amour by Marivaux. The study aims to examine in what sense the notion of polemic (argument, controversy) which is often manifested in terms of aggression, violence, and passion can be applied to the field of literature as a convincing (relevant, adequate) tool of analysis. In other words if we distance ourselves from the literature of combat and epidictic (criticizing) discourse of blame whose sole aim is to reduce (confine) the other to silence through disqualifying or converting him, how can we use pertinently the notion of polemic in dialogues where normally gallantry, politeness and civility should prevail

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely