Limbrecht-Ecklundt K, Werner P, Traue H C, Al-Hamadi A, Walter S
Schmerzmedizin und Schmerzpsychologie, Zentrum für Anästhesiologie und Intensivmedizin, Klinik und Poliklinik für Anästhesiologie, Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Deutschland.
Institut für Informations- und Kommunikationstechnik, Otto-von-Guericke-Universität Magdeburg, Universitätsplatz 2, 39106, Magdeburg, Deutschland.
Schmerz. 2016 Jun;30(3):248-56. doi: 10.1007/s00482-016-0105-x.
The monitoring of facial expressions to assess pain intensity provides a way to determine the need for pain medication in patients who are not able to do so verbally.
In this study two methods for facial expression analysis - Facial Action Coding System (FACS) and electromyography (EMG) of the zygomaticus muscle and corrugator supercilii - were compared to verify the possibility of using EMG for pain monitoring.
Eighty-seven subjects received painful heat stimuli via a thermode on the right forearm in two identical experimental sequences - with and without EMG recording.
With FACS, pain threshold and pain tolerance could be distinguished reliably. Multiple regression analyses indicated that some facial expressions had a predictive value. Correlations between FACS and pain intensity and EMG and pain intensity were high, indicating a closer relationship for EMG and increasing pain intensity. For EMG and FACS, a low correlation was observed, whereas EMG correlates much better with pain intensity.
Results show that the facial expression analysis based on FACS represents a credible method to detect pain. Because of the expenditure of time and personal costs, FACS cannot be used properly until automatic systems work accurately. The use of EMG seems to be helpful in the meantime to enable continuous pain monitoring for patients with acute post-operative pain.
对面部表情进行监测以评估疼痛强度，为确定无法通过言语表达的患者是否需要使用止痛药物提供了一种方法。
在本研究中，对两种面部表情分析方法——面部动作编码系统（FACS）以及颧大肌和皱眉肌的肌电图（EMG）——进行比较，以验证使用肌电图进行疼痛监测的可能性。
87名受试者在两个相同的实验序列中，通过置于右前臂的热刺激器接受疼痛性热刺激，其中一个序列记录肌电图，另一个不记录。
使用FACS能够可靠地区分疼痛阈值和疼痛耐受力。多元回归分析表明，一些面部表情具有预测价值。FACS与疼痛强度之间以及EMG与疼痛强度之间的相关性较高，表明EMG与疼痛强度增加之间的关系更为密切。对于EMG和FACS，观察到两者相关性较低，而EMG与疼痛强度的相关性要好得多。
结果表明，基于FACS的面部表情分析是一种检测疼痛的可靠方法。由于时间成本和人力成本较高，在自动系统能够准确工作之前，FACS无法得到妥善应用。与此同时，使用EMG似乎有助于对急性术后疼痛患者进行持续的疼痛监测。
