Pain Clinic, Department of Anaesthesia and Intensive Care, Helsinki University Central Hospital, PO Box 140, Helsinki FIN-00029 HUS, Finland.
Br J Anaesth. 2012 May;108(5):838-44. doi: 10.1093/bja/aes001. Epub 2012 Feb 26.
Photoplethysmographic pulse wave amplitude (PPGA) and heart rate (HR) can be used to measure cold, nociception-induced autonomic responses, or both. The aim of our study was to correlate the intensity of experimental pain to changes in physiological variables reflecting the autonomic nervous system response to pain.
PPGA, HR, and subjective measurements of pain intensity were measured in 29 healthy male volunteers during two heat stimuli (43°C and 48°C) and the cold pressor test (CPT). Surgical pleth index (SPI), autonomic nervous system state (ANSS), and ANSS index (ANSSi) were calculated using PPGA and HR.
Pain intensity scores increased on the average by 1.6, 3.5, and 8.1 for the 43°C, 48°C, and CPT stimuli, respectively. The pain intensity scores for all three stimuli groups were significantly different from each other (P<0.001). All three stimuli changed HR, PPGA, SPI, ANSS, and ANSSi values significantly from their respective baseline values (P<0.001 for all). Heat stimuli-induced pain intensity did not correlate with the magnitude of the respective changes in HR, PPGA, SPI, ANSS, and ANSSi. CPT-induced pain intensity correlated with the magnitude of the respective changes in HR, PPGA, SPI, ANSS, and ANSSi. PPGA, ANSSi, ANSS, and SPI differentiated between heat and cold stimuli-induced pain.
All three thermal stimuli produced a significant change in photoplethysmograph-derived parameters. All photoplethysmograph-derived parameters appear to be suitable to study autonomic nervous system activation.
光体积描记脉搏波幅度（PPGA）和心率（HR）可用于测量冷觉、伤害性刺激引起的自主反应，或两者兼而有之。我们的研究旨在将实验性疼痛强度与反映疼痛自主神经反应的生理变量变化相关联。
在 29 名健康男性志愿者中，在两种热刺激（43°C 和 48°C）和冷加压试验（CPT）期间测量 PPGA、HR 和疼痛强度的主观测量值。使用 PPGA 和 HR 计算手术 pleth 指数（SPI）、自主神经系统状态（ANSS）和 ANSS 指数（ANSSi）。
疼痛强度评分平均增加 1.6、3.5 和 8.1，分别用于 43°C、48°C 和 CPT 刺激。所有三种刺激组的疼痛强度评分彼此之间存在显著差异（P<0.001）。所有三种刺激均显著改变了 HR、PPGA、SPI、ANSS 和 ANSSi 的基线值（所有 P<0.001）。热刺激引起的疼痛强度与各自 HR、PPGA、SPI、ANSS 和 ANSSi 变化的幅度无关。CPT 引起的疼痛强度与各自 HR、PPGA、SPI、ANSS 和 ANSSi 变化的幅度相关。PPGA、ANSSi、ANSS 和 SPI 区分了热和冷刺激引起的疼痛。
所有三种热刺激均导致光体积描记法衍生参数发生显著变化。所有光体积描记法衍生参数似乎都适合研究自主神经系统激活。
