Rezvani Mehran, Alebouyeh Mahmoud-Reza, Imani Farnad, Entezary Saeid Reza, Mohseni Masood
Department of Anesthesiology, Isfahan University of Medical Sciences, Isfahan, Iran.
Anesth Pain Med. 2013 Spring;2(4):178-81. doi: 10.5812/aapm.7254. Epub 2013 Mar 26.
Several methods for assessment of severity of pain have been proposed but all of them are subjective.
This study evaluated the association concerning changes in electrical resistance (ER) between two acupuncture points and severity of postoperative pain in order to define an objective measurement of pain.
In a cross-sectional study, 50 patients undergoing lower extremity orthopedic surgery with postoperative moderate to severe pain (VAS > 4,) were consecutively enrolled. In the recovery room, the patients' pain scores were assessed and in patients with VAS > 4, the electrical resistance between Li4 and Li11 acupuncture points as well as pain scores was measured prior and following analgesic administration.
Following meperidine use, the mean VAS significantly decreased and the ER between the two acupoints was significantly increased. However, Pearson correlation analysis did not reveal any association between the trends of pain intensity and ER (P > 0.05). The ER change in patients operated under epidural anesthesia was significantly less than those who experienced general or spinal anesthesia.
There is a coincidence of pain relief and change in the ER of acupuncture meridians without significant association. The diagnostic value of ER for pain, stress response or any other physiologic outcome needs to be investigated in clinical trials with a well-defined control group, with more accurate instruments and probably in different acupuncture meridians.
已经提出了几种评估疼痛严重程度的方法,但所有这些方法都是主观的。
本研究评估了两个穴位之间电阻(ER)变化与术后疼痛严重程度之间的关联,以确定一种客观的疼痛测量方法。
在一项横断面研究中,连续纳入50例接受下肢骨科手术且术后有中度至重度疼痛(视觉模拟评分法[VAS]>4)的患者。在恢复室中,评估患者的疼痛评分,对于VAS>4的患者,在给予镇痛药物之前和之后测量足三里(Li4)和上巨虚(Li11)穴位之间的电阻以及疼痛评分。
使用哌替啶后,平均VAS显著降低,两个穴位之间的ER显著增加。然而,Pearson相关性分析未显示疼痛强度趋势与ER之间存在任何关联(P>0.05)。硬膜外麻醉下手术患者的ER变化明显小于全身麻醉或脊髓麻醉患者。
疼痛缓解与经络电阻变化存在巧合,但无显著关联。ER对疼痛、应激反应或任何其他生理结果的诊断价值需要在有明确对照组的临床试验中,使用更精确的仪器,可能在不同经络中进行研究。