Department of System Cybernetics, Graduate School of Engineering, Hiroshima University, 1-4-1 Kagamiyama, Higashi-Hiroshima, Hiroshima, 739-8527, Japan.
College of Engineering, Academic Institute, Shizuoka University, 3-5-1, Johoku, Naka-ku, Hamamatsu, Shizuoka, 432-8561, Japan.
Sci Rep. 2018 Feb 15;8(1):3091. doi: 10.1038/s41598-018-21223-1.
In clinical practice, subjective pain evaluations, e.g., the visual analogue scale and the numeric rating scale, are generally employed, but these are limited in terms of their ability to detect inaccurate reports, and are unsuitable for use in anesthetized patients or those with dementia. We focused on the peripheral sympathetic nerve activity that responds to pain, and propose a method for evaluating pain sensation, including intensity, sharpness, and dullness, using the arterial stiffness index. In the experiment, electrocardiogram, blood pressure, and photoplethysmograms were obtained, and an arterial viscoelastic model was applied to estimate arterial stiffness. The relationships among the stiffness index, self-reported pain sensation, and electrocutaneous stimuli were examined and modelled. The relationship between the stiffness index and pain sensation could be modelled using a sigmoid function with high determination coefficients, where R ≥ 0.88, p < 0.01 for intensity, R ≥ 0.89, p < 0.01 for sharpness, and R ≥ 0.84, p < 0.01 for dullness when the stimuli could appropriately evoke dull pain.
在临床实践中，通常采用主观疼痛评估，例如视觉模拟评分法和数字评分法，但这些方法在检测不准确报告方面的能力有限，并且不适合用于麻醉患者或痴呆患者。我们关注对疼痛有反应的外周交感神经活动，并提出了一种使用动脉僵硬度指数评估疼痛感觉（包括强度、锐度和钝度）的方法。在实验中，我们获得了心电图、血压和光体积描记图，并应用动脉粘弹性模型来估计动脉僵硬度。我们还研究和建模了僵硬指数、自我报告的疼痛感觉和皮肤电刺激之间的关系。使用具有高确定系数的 sigmoid 函数可以对僵硬指数和疼痛感觉之间的关系进行建模，当刺激能够适当引起钝痛时，强度的 R 值≥0.88，p<0.01，锐度的 R 值≥0.89，p<0.01，钝度的 R 值≥0.84，p<0.01。
