Department of Internal Medicine, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.
Pain Med. 2013 Aug;14(8):1192-201. doi: 10.1111/pme.12133. Epub 2013 May 9.
When patients cannot indicate pain, physiological parameters may be useful. We tested whether heart rate variability (HRV) parameters, as reflection of sympathetic and vagal tone, can be used to quantify pain intensity.
Prospective study.
A standardized heat stimulus was applied to the forearm in 75 healthy volunteers during three study periods of 2 minutes.
Before and after each application, pain intensity was measured by a visual analog scale (VAS) and inter beat interval (IBI) was recorded. Standard deviation of normal to normal beat intervals (SDNN) of the IBI, the power of the low (LF, 0.07-0.14 Hz) and high frequency (HF, 0.15-0.50 Hz) band, and LF/HF ratio were calculated. Log transformation resulted in normal distribution. Correlation between HRV parameters and pain intensity was assessed by Pearson's correlation coefficient.
Data from 73 volunteers (44 women) could be analyzed. The mean age was 30 ± 11 years. Compared with baseline, during all heat periods, pain intensity measured by VAS increased from 2 ± 3 mm, 3 ± 5 mm, and 2 ± 4 mm, to 40 ± 20 mm, 42 ± 21 mm, and 44 ± 22 mm, respectively. Log transformed SDNN (lnSDNN) and LF (lnLF) decreased; lnSDNN from 4.0 ± 0.4 to 3.9 ± 0.5, P = 0.002; 4.0 ± 0.4 to 3.9 ± 0.5, P = 0.016; and 4.1 ± 0.4 to 3.9 ± 0.4, P = 0.004, respectively; lnLF from 6.3 ± 1.0 to 6.1 ± 1.2, P = 0.001; 6.4 ± 1.0 to 6.2 ± 1.1, P = 0.019; and 6.5 ± 1.0 to 6.2 ± 1.1, P = 0.020, respectively. No correlation of any HRV parameter with VAS score was found.
HRV parameters may detect responses to heat pain, but are not suitable to assess pain intensity.
当患者无法表达疼痛时，生理参数可能有用。我们测试了心率变异性（HRV）参数是否可以作为交感神经和迷走神经张力的反映来量化疼痛强度。
前瞻性研究。
在三个 2 分钟的研究期间，将标准化的热刺激应用于 75 名健康志愿者的前臂。
在每次应用前后，通过视觉模拟量表（VAS）测量疼痛强度，并记录心跳间隔（IBI）。计算 IBI 的正常到正常心跳间隔（SDNN）、低频（LF，0.07-0.14 Hz）和高频（HF，0.15-0.50 Hz）带的功率以及 LF/HF 比值。对数转换导致正态分布。通过 Pearson 相关系数评估 HRV 参数与疼痛强度之间的相关性。
对 73 名志愿者（44 名女性）的数据进行了分析。平均年龄为 30±11 岁。与基线相比，在所有热期，VAS 测量的疼痛强度均增加，分别为 2±3mm、3±5mm 和 2±4mm，至 40±20mm、42±21mm 和 44±22mm。SDNN（lnSDNN）和 LF（lnLF）的对数转换减少；lnSDNN 从 4.0±0.4 降至 3.9±0.5，P=0.002；4.0±0.4 降至 3.9±0.5，P=0.016；4.1±0.4 降至 3.9±0.4，P=0.004，分别为；lnLF 从 6.3±1.0 降至 6.1±1.2，P=0.001；6.4±1.0 降至 6.2±1.1，P=0.019；6.5±1.0 降至 6.2±1.1，P=0.020，分别为。未发现任何 HRV 参数与 VAS 评分之间存在相关性。
HRV 参数可能可以检测到对热痛的反应，但不适合评估疼痛强度。
