title: Sensory evoked facial muscle electromyography for the quantification of acute labor pain.
abstract: Assessment of the adequacy of epidural analgesia for acute pain management can be difficult on occasion. This investigation used non-invasive sensory evoked facial muscle electromyography (SEFE) as well as a Verbal Assessment Scores (VAS) to assess severe pain in healthy parturients during the first stage of active labor. Institutional Review Board approval and patient informed consent were obtained from 12 healthy parturients who were in active labor and who had requested epidural analgesia for labor pain. SEFE microvoltage was recorded prior to epidural placement when a patient reported severe pain and again when a patient reported no pain with a subsequent uterine contraction. VAS assessments (0 = no pain and 10 = the worst pain ever experienced) were also recorded at identical time intervals. Statistical analysis was done using the paired two tailed Student's t-test. Each patient served as their own control. A statistically significant decrease in SEFE microvoltage (p < 0.001) was noted when analgesia was established (VAS = 0) in each patient. It was concluded in this pilot study that SEFE can be effective in quantifying acute severe nociception and thus can provide a continuous objective indicator of the effectiveness of analgesic regimens in an acute obstetric pain setting. Its applicability in other acute pain areas remains to be investigated.
authors.affiliation: Department of Anesthesiology, University of Louisville School of Medicine, KY 40291.
authors.forename: W E
authors.initials: WE
authors.lastname: Ackerman
authors.forename: P J
authors.initials: PJ
authors.lastname: Andrews
authors.forename: M
authors.initials: M
authors.lastname: Juneja
authors.forename: V
authors.initials: V
authors.lastname: Cases-Cristobal
authors.forename: H P
authors.initials: HP
authors.lastname: Edmonds
authors.forename: B R
authors.initials: BR
authors.lastname: Rigor
mesh_terms: D000208:Acute Disease; D000328:Adult; D016362:Analgesia, Obstetrical; D004576:Electromyography; D005073:Evoked Potentials, Somatosensory; D005152:Facial Muscles / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007743:Labor, Obstetric / Q000502:physiology*; D010147:Pain Measurement; D010865:Pilot Projects; D011247:Pregnancy