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目的建立接触性热痛诱发电位(CHEP)的检测方法,估测介导此诱发电位的外周神经传导速度。方法受试者取卧位,应用 CHEP 刺激器,于两个强度水平(49.5℃和54.5℃)应用可调节脉冲,刺激部位为鱼际肌、手背、前臂的掌侧面。受试者在每次刺激后,按照视觉模拟评分标准对刺激强度分级。以 Keypoint 仪器记录,记录点为 Cz 和 Pz。测定刺激强度和疼痛分级的关系、诱发电位的主要成分及外周神经传导速度。结果刺激强度和疼痛分级的关系为:49.5℃和54.5℃刺激鱼际肌皮肤,疼痛分级分别为(3.2±0.3)、(4.4±0.5)级;54.5℃刺激手背和前臂掌侧面皮肤,疼痛分级分别为(6.3±0.8)、(7.2±0.5)级。于记录点记录到3个主要成分:Cz/N550、Cz/P750和 Pz/P1000。介导此诱发电位的外周神经传导速度分别为(12.9±7.5)、(1.7±0.4)m/s,分别与 Aδ纤维和 C 纤维的传导速度相对应。结论 CHEP 能较为稳定、可靠地引出,介导此诱发电位的外周神经为Aδ纤维和 C 纤维。
OBJECTIVE: To establish a method for the detection of contact hyperthermia evoked potentials (CHEP) and to estimate the peripheral nerve conduction velocity that mediates this evoked potential. Methods Subjects were placed in the supine position, and the application of adjustable impulses at two intensities (49.5 ° C and 54.5 ° C) using a CHEP stimulator was performed on the palmar side of the muscle, back and forearms. Subjects rated the intensity of the stimuli according to visual analogue scale criteria after each stimulation. Record with Keypoint instruments, recording points Cz and Pz. The relationship between stimulus intensity and pain grade was determined, and the main components of evoked potentials and peripheral nerve conduction velocity were measured. Results The relationship between the intensity of stimulation and the grading of pain was as follows: the skin of the atresia muscle was stimulated at 49.5 ℃ and 54.5 ℃, the pain grading was (3.2 ± 0.3) and (4.4 ± 0.5) respectively; Respectively (6.3 ± 0.8), (7.2 ± 0.5) level. Three main components were recorded at the record points: Cz / N550, Cz / P750 and Pz / P1000. The peripheral nerve conduction velocity that mediated this evoked potential was (12.9 ± 7.5) and (1.7 ± 0.4) m / s, respectively, which corresponded to the conduction velocity of Aδ fiber and C fiber, respectively. Conclusion CHEP can be induced more reliably and reliably. The peripheral nerve mediating this evoked potential is Aδ fiber and C fiber.