Aufiero Molly, Stankewicz Holly, Quazi Shaila, Jacoby Jeanne, Stoltzfus Jill
St. Luke's University Hospital, Department of Emergency Medicine, Bethlehem, Pennsylvania.
Aria Health Network, Department of Emergency Medicine, Philadelphia, Pennsylvania.
West J Emerg Med. 2017 Jun;18(4):737-742. doi: 10.5811/westjem.2017.1.32723. Epub 2017 Apr 17.
Pain is a common emergency department (ED) complaint. It is important to understand the differences in pain perception among different ethnic and demographic populations.
We applied a standardized painful stimulus to Caucasian and Latino adult patients to determine whether the level of pain reported differed depending on ethnicity (N=100; 50 Caucasian [C], 50 Latino [L] patients) and gender (N=100; 59 female, 41 male). Patients had an initial pain score of 0 or 1. A blood pressure cuff was inflated 20 mm HG above the patient's systolic blood pressure and held for three minutes. Pain scores, using both a 10-cm visual analog scale (VAS) and a five-point Likert scale, were taken at the point of maximal stimulus (2 minutes 50 seconds after inflation), and at one- and two-minute intervals post deflation.
There was a statistically significant difference between the Likert scale scores of Caucasian and Latino patients at 2min 50sec (mean rank: 4.35 [C] vs. 5.75 [L], p<0.01), but not on the VAS (mean value: 2.94 [C] vs. 3.46 [L], p=0.255). Women had a higher perception of pain than males at 2min 50sec on the VAS (mean value: 3.86 [F] vs. 2.24 [M], p<0.0001), and the Likert scale (mean rank: 5.63 [F] vs. 4.21 [M], p<0.01).
Latinos and women report greater pain with a standardized pain stimulus as compared to Caucasians and men.
疼痛是急诊科常见的主诉。了解不同种族和人口群体之间疼痛感知的差异很重要。
我们对成年白种人和拉丁裔患者施加标准化的疼痛刺激，以确定报告的疼痛程度是否因种族（N = 100；50名白种人[C]，50名拉丁裔[L]患者）和性别（N = 100；59名女性，41名男性）而有所不同。患者初始疼痛评分为0或1。将血压袖带充气至高于患者收缩压20 mmHg并保持三分钟。在最大刺激点（充气后2分50秒）以及放气后1分钟和2分钟间隔时，使用10厘米视觉模拟量表（VAS）和五点李克特量表记录疼痛评分。
在2分50秒时，白种人和拉丁裔患者的李克特量表评分存在统计学显著差异（平均秩次：4.35 [C] 对5.75 [L]，p < 0.01），但在VAS上无差异（平均值：2.94 [C] 对3.46 [L]，p = 0.255）。在VAS上，女性在2分50秒时对疼痛的感知高于男性（平均值：3.86 [F] 对2.24 [M]，p < 0.0001），在李克特量表上也是如此（平均秩次：5.63 [F] 对4.21 [M]，p < 0.01）。
与白种人和男性相比，拉丁裔和女性在接受标准化疼痛刺激时报告的疼痛程度更高。
