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Observing continuous change in heart rate variability and photoplethysmography-derived parameters during the process of pain production/relief with thermal stimuli

Authors Ye JJ, Lee KT, Lin JS, Chuang CC

Received 2 December 2016

Accepted for publication 12 January 2017

Published 6 March 2017 Volume 2017:10 Pages 527—533

DOI https://doi.org/10.2147/JPR.S129287

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 2

Editor who approved publication: Dr Michael Schatman

Jing-Jhao Ye, Kuan-Ting Lee, Jing-Siang Lin, Chiung-Cheng Chuang

Department of Biomedical Engineering, Chung Yuan Christian University, Chung Li, Taiwan

Abstract: Continuously monitoring and efficiently managing pain has become an important issue. However, no study has investigated a change in physiological parameters during the process of pain production/relief. This study modeled the process of pain production/relief using ramped thermal stimulation (no pain: 37°C water, process of pain production: a heating rate of 1°C/min, and subject feels pain: water kept at the painful temperature for each subject, with each segment lasting 10 min). In this duration, the variation of the heat rate variability and photoplethysmography-derived parameters was observed. A total of 40 healthy individuals participated: 30 in the trial group (14 males and 16 females with a mean age of 22.5±1.9 years) and 10 in the control group (7 males and 3 females with a mean age of 22.5±1.3 years). The results showed that the numeric rating scale value was 5.03±1.99 when the subjects felt pain, with a temperature of 43.54±1.70°C. Heart rate, R-R interval, low frequency, high frequency, photoplethysmography amplitude, baseline, and autonomic nervous system state showed significant changes during the pain production process, but these changes differed during the period Segment D (painful temperature 10: min). In summary, the study observed that physiological parameters changed qualitatively during the process of pain production and relief and found that the high frequency, low frequency, and photoplethysmography parameters seemed to have different responses in four situations (no pain, pain production, pain experienced, and pain relief). The trends of these variations may be used as references in the clinical setting for continuously observing pain intensity.

Keywords: pain production, heart rate variability, photoplethysmography, thermal stimuli

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