title: Effect of heat-induced pain stimuli on pulse transit time and pulse wave amplitude in healthy volunteers.
abstract: Pain is commonly assessed subjectively by interpretations of patient behaviour and/or reports from patients. When this is impossible the availability of a quantitative objective pain assessment tool based on objective physiological parameters would greatly benefit clinical practice and research beside the standard self-report tests. Vasoconstriction is one of the physiological responses to pain. The aim of this study was to investigate whether pulse transit time (PTT) and pulse wave amplitude (PWA) decrease in response to this vasoconstriction when caused by heat-induced pain. The PTT and PWA were measured in healthy volunteers, on both index fingers using photoplethysmography and electrocardiography. Each subject received 3 heat-induced pain stimuli using a Temperature-Sensory Analyzer thermode block to apply a controlled, increasing temperature from 32.0 °C to 50.0 °C to the skin. After reaching 50.0 °C, the thermode was immediately cooled down to 32.0 °C. The study population was divided into 2 groups with a time-interval between the stimuli 20s or 60s. The results showed a significant (p  <  0.05) decrease of both PTT and PWA on the stimulated and contralateral side. Moreover, there was no significant difference between the stimulated and contralateral side. The time-interval of 20s was too short to allow PTT and PWA to return to baseline values and should exceed 40s in future studies. Heat-induced pain causes a decrease of PTT and PWA. Consequently, it is expected that, in the future, PTT and PWA may be applied as objective indicators of pain, either beside the standard self-report test, or when self-report testing is impossible.
authors.affiliation: Department of Anesthesiology, Laboratory of Experimental Anesthesiology, Erasmus University Medical Center Rotterdam, The Netherlands.
authors.forename: Marit H N
authors.initials: MH
authors.lastname: van Velzen
authors.forename: Arjo J
authors.initials: AJ
authors.lastname: Loeve
authors.forename: Minke C
authors.initials: MC
authors.lastname: Kortekaas
authors.forename: Sjoerd P
authors.initials: SP
authors.lastname: Niehof
authors.forename: Egbert G
authors.initials: EG
authors.lastname: Mik
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Stolker
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D064368:Healthy Volunteers; D006358:Hot Temperature / Q000009:adverse effects*; D006801:Humans; D008297:Male; D010146:Pain / Q000209:etiology* / Q000503:physiopathology*; D010147:Pain Measurement; D063177:Pulse Wave Analysis; D055815:Young Adult