Chicago Medical School, Rosalind Franklin University, Chicago, Illinois, USA.
Department of Obstetrics and Gynecology, NorthShore University HealthSystem, Evanston, Illinois, USA.
J Obstet Gynaecol Res. 2021 Apr;47(4):1472-1480. doi: 10.1111/jog.14663. Epub 2021 Feb 15.
Prior research has primarily focused on static pain assessment, largely ignoring the dynamic nature of pain over time. We used a novel assessment tool for characterizing pain duration, frequency, and amplitude in women with dysmenorrhea and evaluated how these metrics were affected by naproxen treatment.
Dysmenorrheic women (n = 25) rated their menstrual pain by squeezing a pressure bulb proportional to the magnitude of their pain. To evaluate whether bulb squeezing was affected by naproxen, we compared parameters before and after naproxen. We also analyzed the correlation between pain relief on a numerical rating scale to changes in bulb squeezing parameters. Random bulb-squeezing activity in pain-free participants (n = 14) was used as a control for nonspecific effects or bias.
In dysmenorrheic women, naproxen reduced the duration of the squeezing during a painful bout, the number of painful bouts and bout intensity. Before naproxen, the correlation between these bulb squeeze parameters and self-reported pain on numeric rating scale was not significant (R = 0.12, p = 0.304); however, there was a significant correlation between changes in bulb squeeze activity and self-reported pain relief after naproxen (R = 0.55, p < 0.001).
Our study demonstrates a convenient technique for continuous pain assessment, capturing three different dimensions: duration, frequency, and magnitude. Naproxen may act by reducing the duration and frequency of episodic pain in addition to reducing the severity. After further validation, these methods could be used for other pain conditions for deeper phenotyping and assessing novel treatments.
先前的研究主要集中在静态疼痛评估上，在很大程度上忽略了疼痛随时间的动态变化。我们使用一种新的评估工具来描述痛经女性的疼痛持续时间、频率和幅度，并评估这些指标如何受到萘普生治疗的影响。
痛经女性（n=25）通过挤压一个与疼痛程度成正比的压力球来评估月经疼痛。为了评估萘普生是否影响球挤压，我们比较了萘普生治疗前后的参数。我们还分析了数字评分量表上的疼痛缓解与球挤压参数变化之间的相关性。无痛参与者（n=14）的随机球挤压活动被用作非特异性影响或偏差的对照。
在痛经女性中，萘普生减少了疼痛发作期间挤压的持续时间、疼痛发作次数和发作强度。在萘普生治疗前，这些球挤压参数与数字评分量表上自我报告的疼痛之间没有显著相关性（R=0.12，p=0.304）；然而，在萘普生治疗后，球挤压活动的变化与自我报告的疼痛缓解之间存在显著相关性（R=0.55，p<0.001）。
我们的研究展示了一种用于连续疼痛评估的便捷技术，可捕捉三个不同的维度：持续时间、频率和幅度。萘普生可能通过减少发作性疼痛的持续时间和频率以及减轻疼痛程度来发挥作用。在进一步验证后，这些方法可用于其他疼痛状况，以进行更深入的表型分析和评估新的治疗方法。
