A New Real-time Method for Detecting the Effect of Fentanyl Using the Preoperative Pressure Pain Threshold and Narcotrend Index

A challenge is always presented when attempting to measure the pain an individual patient experiences. Unfortunately, present technologies rely nearly exclusively on subjective techniques. Using these current techniques, a physician may use a manually operated algometer and a series of questionnaires to gauge an individual patient’s pain scale. Unfortunately these devices and test methods have been suggested to introduce error due to variability and inconsistent testing methods. Some studies have shown large variability, while others have shown minimal variability, both between patients and within the same patient during multiple testing sessions. Recent studies have also shown a lack of correlation between pain threshold and pain tolerance in pain sensitivity tests. Hand-held algometer devices can be difficult to maintain consistent application rates over multiple test periods, possibly adding to widespread variability. Furthermore, there are limited test results that correlate pain ratings with biological measures in real time. The computer-controlled pressure algometer described is not hand-held or dependent on significant examiner input. This new device is capable of recording electrocardiograph (ECG), blood pressure (BP), pressure pain threshold (PPT), and pressure pain tolerance (PPTol) in real time. One major goal is the capability of correlating pain stimuli with algometer pressure, heart rate, and blood pressure. If a predictable correlation between vital signs and pain could be established, significant gains in the understanding of pain could result. Better understanding of pain will ultimately lead to improvements in treatment and diagnosis of pain conditions, helping patients and physicians alike.

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Metformin increases pressure pain threshold in lean PCOS women

Endocrine Abstracts ◽

10.1530/endoabs.49.ep890 ◽

2017 ◽

Author(s):

Marta Kialka ◽

Tomasz Milewicz ◽

Krystyna Sztefko ◽

Iwona Rogatko ◽

Renata Majewska

Keyword(s):

Pain Threshold ◽

Pressure Pain Threshold ◽

Pressure Pain

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Short-term Change on Pressure Pain Threshold and Vertical Jump when Foam Roll Exercises and Vibration Foam Roll Exercises

Archives of Orthopedic and Sports Physical Therapy ◽

10.24332/aospt.2017.14.1.16 ◽

2018 ◽

Vol 14 (1) ◽

pp. 137-145

Author(s):

Sangwan Han

Keyword(s):

Pain Threshold ◽

Vertical Jump ◽

Pressure Pain Threshold ◽

Short Term ◽

Pressure Pain ◽

Short Term Change ◽

Term Change

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Pressure Pain Threshold of Shoulder Muscles in VDT Workers

Korean Journal of Occupational and Environmental Medicine ◽

10.35371/kjoem.1996.8.1.15 ◽

1996 ◽

Vol 8 (1) ◽

pp. 15 ◽

Cited By ~ 2

Author(s):

Byoung Soon Shin ◽

Chung Yill Park

Keyword(s):

Pain Threshold ◽

Pressure Pain Threshold ◽

Pressure Pain ◽

Shoulder Muscles

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A novel metric of reliability in pressure pain threshold measurement

Scientific Reports ◽

10.1038/s41598-021-86344-6 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Bernard Liew ◽

Ho Yin Lee ◽

David Rügamer ◽

Alessandro Marco De Nunzio ◽

Nicola R. Heneghan ◽

...

Keyword(s):

Mixed Models ◽

Variance Components ◽

Pain Threshold ◽

Intraclass Correlation ◽

Pressure Pain Threshold ◽

Total Variance ◽

Lumbar Region ◽

Pressure Pain ◽

Pressure Algometer ◽

Testing Protocols

AbstractThe inter-session Intraclass Correlation Coefficient (ICC) is a commonly investigated and clinically important metric of reliability for pressure pain threshold (PPT) measurement. However, current investigations do not account for inter-repetition variability when calculating inter-session ICC, even though a PPT measurement taken at different sessions must also imply different repetitions. The primary aim was to evaluate and report a novel metric of reliability in PPT measurement: the inter-session-repetition ICC. One rater recorded ten repetitions of PPT measurement over the lumbar region bilaterally at two sessions in twenty healthy adults using a pressure algometer. Variance components were computed using linear mixed-models and used to construct ICCs; most notably inter-session ICC and inter-session-repetition ICC. At 70.1% of the total variance, the source of greatest variability was between subjects ($${\sigma }_{subj}^{2}$$ σ subj 2 = 222.28 N2), whereas the source of least variability (1.5% total variance) was between sessions ($${\sigma }_{sess}^{2}$$ σ sess 2 = 4.83 N2). Derived inter-session and inter-session-repetition ICCs were 0.88 (95%CI: 0.77 to 0.94) and 0.73 (95%CI: 0.53 to 0.84) respectively. Inter-session-repetition ICC provides a more conservative estimate of reliability than inter-session ICC, with the magnitude of difference being clinically meaningful. Quantifying individual sources of variability enables ICC construction to be reflective of individual testing protocols.

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Comparative study of the effectiveness of a low-pressure hyperbaric oxygen treatment and physical exercise in women with fibromyalgia: randomized clinical trial

Therapeutic Advances in Musculoskeletal Disease ◽

10.1177/1759720x20930493 ◽

2020 ◽

Vol 12 ◽

pp. 1759720X2093049

Author(s):

Ruth Izquierdo-Alventosa ◽

Marta Inglés ◽

Sara Cortés-Amador ◽

Lucia Gimeno-Mallench ◽

Núria Sempere-Rubio ◽

...

Keyword(s):

Physical Exercise ◽

Physical Performance ◽

Hyperbaric Oxygen ◽

Functional Capacity ◽

Pain Threshold ◽

Cortical Excitability ◽

Pressure Pain Threshold ◽

Low Pressure ◽

Pressure Pain ◽

Perceived Pain

Background: Fibromyalgia (FM) is characterized by chronic pain and fatigue, among other manifestations, thus advising interventions that do not aggravate these symptoms. The main purpose of this study is to analyse the effect of low-pressure hyperbaric oxygen therapy (HBOT) on induced fatigue, pain, endurance and functional capacity, physical performance and cortical excitability when compared with a physical exercise program in women with FM. Methods: A total of 49 women with FM took part in this randomized controlled trial. They were randomly allocated to three groups: physical exercise group (PEG, n = 16), low-pressure hyperbaric oxygen therapy group (HBG, n = 17) and control group (CG, n = 16). Induced fatigue, perceived pain, pressure pain threshold, endurance and functional capacity, physical performance and cortical excitability were assessed. To analyse the effect of the interventions, two assessments, that is, pre and post intervention, were carried out. Analyses of the data were performed using two-way mixed multivariate analysis of variance. Results: The perceived pain and induced fatigue significantly improved only in the HBG ( p < 0.05) as opposed to PEG and CG. Pressure pain threshold, endurance and functional capacity, and physical performance significantly improved for both interventions ( p < 0.05). The cortical excitability (measured with the resting motor threshold) did not improve in any of the treatments ( p > 0.05). Conclusions: Low-pressure HBOT and physical exercise improve pressure pain threshold, endurance and functional capacity, as well as physical performance. Induced fatigue and perceived pain at rest significantly improved only with low-pressure HBOT. Trial registration: ClinicalTrials.gov identifier NCT03801109.

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