University Department of Anaesthesiology and Pain Therapy, University Hospital of Bern, Inselspital, Bern, Switzerland.
Eur J Pain. 2011 Apr;15(4):376-83. doi: 10.1016/j.ejpain.2010.08.011. Epub 2010 Oct 6.
Quantitative sensory tests are widely used in human research to evaluate the effect of analgesics and explore altered pain mechanisms, such as central sensitization. In order to apply these tests in clinical practice, knowledge of reference values is essential. The aim of this study was to determine the reference values of pain thresholds for mechanical and thermal stimuli, as well as withdrawal time for the cold pressor test in 300 pain-free subjects. Pain detection and pain tolerance thresholds to pressure, heat and cold were determined at three body sites: (1) lower back, (2) suprascapular region and (3) second toe (for pressure) or the lateral aspect of the leg (for heat and cold). The influences of gender, age, height, weight, body-mass index (BMI), body side of testing, depression, anxiety, catastrophizing and parameters of Short-Form 36 (SF-36) were analyzed by multiple regressions. Quantile regressions were performed to define the 5th, 10th and 25th percentiles as reference values for pain hypersensitivity and the 75th, 90th and 95th percentiles as reference values for pain hyposensitivity. Gender, age and/or the interaction of age with gender were the only variables that consistently affected the pain measures. Women were more pain sensitive than men. However, the influence of gender decreased with increasing age. In conclusion, normative values of parameters related to pressure, heat and cold pain stimuli were determined. Reference values have to be stratified by body region, gender and age. The determination of these reference values will now allow the clinical application of the tests for detecting abnormal pain reactions in individual patients.
定量感觉测试广泛应用于人类研究中,用于评估镇痛药的效果,并探索疼痛机制的改变,如中枢敏化。为了将这些测试应用于临床实践,了解参考值是必不可少的。本研究的目的是确定 300 名无痛受试者的机械和热刺激痛觉阈值以及冷加压试验退缩时间的参考值。在三个身体部位(1)下背部、(2)肩胛区和(3)第二脚趾(用于压力)或腿的外侧(用于热和冷)确定疼痛探测和疼痛耐受阈值。通过多元回归分析性别、年龄、身高、体重、体重指数(BMI)、测试侧、抑郁、焦虑、灾难化和简明健康调查问卷 36 项(SF-36)参数对压力、热和冷疼痛的影响。进行分位数回归以定义第 5、10 和 25 百分位数作为疼痛超敏反应的参考值,以及第 75、90 和 95 百分位数作为疼痛低敏反应的参考值。性别、年龄和/或年龄与性别的相互作用是唯一一致影响疼痛测量的变量。女性比男性更敏感。然而,随着年龄的增长,性别影响逐渐减弱。总之,确定了与压力、热和冷疼痛刺激相关的参数的正常值。参考值必须按身体部位、性别和年龄分层。这些参考值的确定将使这些测试能够在个体患者中检测异常疼痛反应的临床应用成为可能。
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