de Jesus Jose Alfredo L, Tristao Rosana M, Storm Hanne, da Rocha Adson F, Campos Dioclecio
University of Brasilia, Brasilia, DF, Brazil.
Annu Int Conf IEEE Eng Med Biol Soc. 2011;2011:1875-9. doi: 10.1109/IEMBS.2011.6090532.
Heart rate variability (HRV), oxygen saturation variability (OSV) and skin conductance activity (SCA) are recognized physiological markers of acute pain. In order to verify which of them has the best correlation with psychophysical parameters of pain (intensity, reactivity, direction, regulation and slope), an observational prospective study was performed, including 41 healthy full term newborns. The measurements studied were the HRV, the OSV, and the following SCA variables: number of waves per second (NWps) and relative area under the curve of waves (AUC). The measurements were performed in periods labeled before, during, and after a heel prick. The variation measured for intensity between periods was significant for the NWps (p=0.001), AUC (p=0.03), HRV (p=0.001) and OSV (p=0.004). Also, the reactivity and direction were significant for all variables, except AUC. The regulation parameter was significant for the variables NWps (p<0.01), AUC (p<0.05), HRV (p<0.01) and OSV (p<0.01). The slope was statistically significant only for the OSV variable (p=0.000). We concluded that the responses of the SCA, HRV and OSV to painful events fit the psychophysical parameters of a physiological marker and serve as valuable measures for pain diagnostic working the use in accordance with the needs of the context.
心率变异性（HRV）、血氧饱和度变异性（OSV）和皮肤电导活动（SCA）是公认的急性疼痛生理指标。为了验证它们中哪一个与疼痛的心理物理参数（强度、反应性、方向、调节和斜率）具有最佳相关性，进行了一项观察性前瞻性研究，纳入了41名健康足月儿。所研究的测量指标为HRV、OSV以及以下SCA变量：每秒波数（NWps）和波曲线下的相对面积（AUC）。测量在足跟采血之前、期间和之后的时间段进行。各时间段之间强度测量的变化在NWps（p = 0.001）、AUC（p = 0.03）、HRV（p = 0.001）和OSV（p = 0.004）方面具有显著性。此外，除AUC外，所有变量的反应性和方向均具有显著性。调节参数在NWps（p<0.01）、AUC（p<0.05）、HRV（p<0.01）和OSV（p<0.01）变量方面具有显著性。斜率仅在OSV变量方面具有统计学显著性（p = 0.000）。我们得出结论，SCA、HRV和OSV对疼痛事件的反应符合生理指标的心理物理参数，并且根据具体情况的需要，可作为疼痛诊断的有价值指标。
