Drummond Peter D
School of Psychology, Murdoch University, 6150, Western Australia.
Clin Auton Res. 2003 Oct;13(5):316-20. doi: 10.1007/s10286-003-0127-1.
The presence of pain may influence autonomic function in patients with painful neurological or cardiovascular disorders. The aim of the present study was to determine whether pain influences cardiac baroreflexes during the Valsalva manoeuvre. Eighteen healthy subjects immersed their hand twice at each temperature in 30 degrees C water and painfully hot (47 degrees C) and cold water (12 degrees C and 7 degrees C) for 2.5 minutes, followed by 5 minute rest periods. During 50% of the immersions, subjects performed the Valsalva manoeuvre (40 mmHg for 30 seconds) starting one minute after their hand entered the water. Pain ratings and heart rate were greater during the 7 degrees C and 47 degrees C immersions than during the 12 degrees C and 30 degrees C immersions. Pain-induced increases in heart rate did not influence peak tachycardia during phase II or III of the Valsalva manoeuvre or peak bradycardia during phase IV, but opposed bradycardia during the post-strain recovery period. Further studies are needed to establish whether pain influences indices of autonomic function during clinical assessment.
疼痛的存在可能会影响患有疼痛性神经或心血管疾病患者的自主神经功能。本研究的目的是确定在瓦尔萨尔瓦动作期间疼痛是否会影响心脏压力反射。18名健康受试者在每个温度下将手分别浸入30摄氏度的水、极热（47摄氏度）和冷水（12摄氏度和7摄氏度）中两次，每次浸泡2.5分钟，随后休息5分钟。在50%的浸泡过程中，受试者在手部入水一分钟后开始进行瓦尔萨尔瓦动作（40 mmHg，持续30秒）。与在12摄氏度和30摄氏度浸泡期间相比，在7摄氏度和47摄氏度浸泡期间疼痛评分和心率更高。疼痛引起的心率增加并未影响瓦尔萨尔瓦动作第二或第三阶段的心动过速峰值或第四阶段的心动过缓峰值，但在用力后恢复期对抗心动过缓。需要进一步研究以确定在临床评估期间疼痛是否会影响自主神经功能指标。
