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目的:通过冷热刺激诱发疼痛,探讨指光电容积脉搏波(PPG)分析技术用于清醒患者疼痛评估和监测的可行性。方法:30例健康男性自愿者将右手按先后顺序分别放入42℃、48℃、3℃水中各90 s,每2个试验间休息10~20 min,记录每次刺激后的数字疼痛评分(NRS),描记入室后20 min(T0)时及每次刺激前及结束后即刻左手食指PPG各30 s,数据做离线分析。结果:与温度刺激前比较,各组刺激后PPGA、PBI均显著降低(P<0.05);刺激后42℃组与48℃组间PBI、PPGA比较差异无统计学意义;与3℃组比较,刺激后42℃组、48℃组PBI、PPGA比较差异均有统计学意义(P<0.05);刺激后三组间NRS比较差异均有统计学意义(P<0.05)。刺激后42℃组与48℃组PBI、PPGA与NRS的相关性均较差;3℃组PBI、PPGA与NRS呈中等强度负相关。结论:轻中度的伤害性刺激可导致PBI、PPGA的改变,但其变化幅度与重度疼痛具有很好的相关性,应用PPG分析技术可评估和监测清醒时温觉刺激引起的疼痛反应。
OBJECTIVE: To explore the feasibility of using photoplethysmography (PPG) analysis in the assessment and monitoring of pain in awake patients through pain induced by cold and hot stimuli. Methods: Thirty healthy male volunteers placed their right hands in 42 ℃, 48 ℃ and 3 ℃ water for 90 seconds respectively, and resumed the interval between 10 and 20 minutes in each of the two experiments. The digital pain scores after each stimulation were recorded NRS). Data were analyzed offline at 20 min (T0) and 30 s before and immediately after each stimulus. Results: Compared with pre-temperature stimulation, PPGA and PBI decreased significantly after stimulation (P <0.05). There was no significant difference in PBI and PPGA between 42 ℃ and 48 ℃ after stimulation There were significant differences in PBI and PPGA between 42 ℃ and 48 ℃ after stimulation (P <0.05). There was significant difference in NRS between the three groups after stimulation (P <0.05). The correlation between PBI, PPGA and NRS in 42 ℃ group and 48 ℃ group was poor after stimulation. PBI, PPGA and NRS in 3 ℃ group showed a moderate negative correlation. CONCLUSIONS: Mild to moderate noxious stimulation can lead to changes in PBI and PPGA, but its magnitude of change correlates well with severe pain. PPG analysis can be used to assess and monitor the pain response induced by warm sensation during wakefulness.