Intensive Care and Department of Pediatric Surgery, Erasmus University Medical Center-Sophia Children's Hospital, PO Box 2040, 3000 CA Rotterdam, The Netherlands.
Early Hum Dev. 2012 Jul;88(7):487-91. doi: 10.1016/j.earlhumdev.2011.12.006. Epub 2012 Jan 13.
Experiencing pain at newborn age may have consequences on one's somatosensory perception later in life. Children's perception for cold and warm stimuli may be determined with the Thermal Sensory Analyzer (TSA) device by two different methods.
This pilot study in 5-year-old children born preterm aimed at establishing whether the TSA method of limits, which is dependent of reaction time, and the method of levels, which is independent of reaction time, would yield different cold and warm detection thresholds. The second aim was to establish possible associations between intellectual ability and the detection thresholds obtained with either method.
A convenience sample was drawn from the participants in an ongoing 5-year follow-up study of a randomized controlled trial on effects of morphine during mechanical ventilation.
Thresholds were assessed using both methods and statistically compared. Possible associations between the child's intelligence quotient (IQ) and threshold levels were analyzed.
The method of levels yielded more sensitive thresholds than did the method of limits, i.e. mean (SD) cold detection thresholds: 30.3 (1.4) versus 28.4 (1.7) (Cohen'sd=1.2, P=0.001) and warm detection thresholds; 33.9 (1.9) versus 35.6 (2.1) (Cohen's d=0.8, P=0.04). IQ was statistically significantly associated only with the detection thresholds obtained with the method of limits (cold: r=0.64, warm: r=-0.52).
The TSA method of levels, is to be preferred over the method of limits in 5-year-old preterm born children, as it establishes more sensitive detection thresholds and is independent of IQ.
新生儿时期经历疼痛可能会对其日后的体感感知产生影响。儿童对冷、热刺激的感知可以通过热感觉分析仪(TSA)设备以两种不同的方法来确定。
本研究为早产儿 5 岁儿童的初步研究,旨在确定依赖于反应时间的 TSA 极限法和不依赖于反应时间的 TSA 水平法是否会产生不同的冷、热觉检测阈值。第二个目的是确定智力能力与两种方法中任何一种方法获得的检测阈值之间可能存在的关联。
从一项正在进行的 5 年随访研究中抽取了一个随机对照试验中机械通气期间吗啡作用的便利样本。
使用两种方法评估阈值,并进行统计学比较。分析了儿童智商(IQ)与阈值之间的可能关联。
水平法比极限法产生更敏感的阈值,即平均(SD)冷觉检测阈值:30.3(1.4)比 28.4(1.7)(Cohen's d=1.2,P=0.001)和温觉检测阈值:33.9(1.9)比 35.6(2.1)(Cohen's d=0.8,P=0.04)。智商仅与极限法检测阈值具有统计学显著相关性(冷觉:r=0.64,温觉:r=-0.52)。
在 5 岁的早产儿中,与极限法相比,TSA 水平法是一种更好的选择,因为它能建立更敏感的检测阈值,且不依赖于智商。