| IntroductionIn clinic, pathological pain is one of the most frequently observed clinical symptoms. It brings to people on the in physiological and psychological hazards,which damage various functions of the human and have a negative effect on human body. The pain has become one of the biggest public health threats, it also reduce labor ability, and become one of the most common and direct reason of absence in the work. The pain could be divided into two types based on the duration time: acute pain and chronic pain. As far as chronic pain is concerned, it can last for a long time. It is complex for both the etiology and the treatment. The clinical workers have always been troubled by the evaluation of pain in the process of diagnosis and treatment.The traditional measurements of pain are diverse, including visual analog scale(VAS), short form Mcgill pain questionnaire (SF-Mcgill) and numeric rating scale sleep interference score(NRSSIS). The VAS and SF-Mcgill are the most common methods. Each method has its advantages and disadvantages, but all have the subjectivity. Therefore,it is urged that more accurate quantitative evaluation methods are needed. PainVision apparatus is a device that can stimulate peripheral nerve. Most measurements take their great advantages in assessment of persistent pain. However,PainVision could measure not only persistent pain but also breakthrough pain.ObjectiveBy evaluating the degree of pain in chronic pain patients in three time points by PainVision apparatus: before receiving the treatment, symptom improvement and before hospital discharge, and comparing with tradional methods, to investigate the application of PainVison apparatus in clinical. Meanwhile, by measuring current perception threshold in normal population, to investigate the effet of the different ages and different body parts on it.MethodsThe study is composed of two parts:Part 1.PainVisionin measurement of pain in the treatment of chronic pain Research objective and grouping: We retrospectively analyzed 106 patients,hospitalized for chronic pain in department of pain management of Ji'nan Central Hospital Affiliated to Shandong University from December 2015 to November 2016 .According to the principal diagnosis, the patients were divided into five groups:postherpetic neuralgia group (group PHN, n=33), cancerous pain group (group CP,n=22), prolapse of lumbar intervertebral disc group (group PLID, n=30), complex regional pain syndrome group (group CRPS, n=11), and cervicalspondylotic radiculopathy group (group CSR, n=10). The degree of pain was evaluated at three time points: before treatment (TO), the pain symptoms were obviously alleviated and VAS score < 40 mm (T1), before hospital discharge (T2). The degree of pain was assessed by PainVision, VAS, SF-Mcgill, NRSSIS. Both persistent pain (PP) and breakthrough pain (BTP) were evaluated.Part 2.PainVisionin quantitative measurement of current perception threshold in general population120 healthy people were divided into 3 groups according to their ages: the people in group I were 18y to 40y; group ? aged 41y to 60y; group III were over 61 years old. The current perception threshold (CPT) was measured by PainVision in six body parts, including left medial forearm (LMF), right medial forearm (RMF), left front ankle (LFA), left back ankle (LBA), right front ankle (RFA), right back ankle(RBA).ResultsPart 1.PainVisionin measurement of pain in the treatment of chronic pain1.1 The evaluation of pain equivalent current (PEC): Compared with T0, PEC values in group PHN, group CP, group PLID and group CSR at T1 and T2 were both decreased significantly (P < 0.05). However, PEC value in group CRPS was decreased significantly just at only T2 (P<0.05). Compared with T1, PEC values in group CP, group PLID, group CSR at T2 were all decreased significantly (P<0.05).1.2 The evaluation of pain ratio for persistent pain (PR-PP): Compared with T0,PR-PP values were significantly decreased in group PHN, group CP, group PLID,group CRPS, and group CSR (P<0.05). Compared with T1, PR-PP values in group CP, group CRPS, and group CSR at T2 were all decreased significantly (P<0.05).1.3 The evaluation of pain degree for persistent pain (PD-PP): Compared with T0, PD-PP values in group PHN, group CP, group PLID and group CSR at T1 and T2 were both decreased significantly (P<0.05). However, PD-PP value in group CRPS was decreased significantly only at T2 (P<0.05). Compared with T1, PD-PP in group CP, group PLID, group CRPS, group CSR were all decreased significantly (P<0.05).1.4 The evaluation of the pain degree for breakthrough pain (PD-BTP):PD-BTP values in group PHN and group CP at T1 and T2 were both decreased significantly (P<0.05).1.5 The correlation comparison of pain degree and VAS, SF-Mcgill and NRSSIS: The relations of PD-PP and VAS were highly correlated at group PHN,group PLID, group CRPS and group CSR (P<0.05). The relations of PD-BTP and VAS were highly correlated at group PHN and group CSR (P<0.05). The relations of PD and SF-Mcgill, NRSSIS were not correlated in five groups (P>0.05).Part 2. PainVisionin in quantitative measurement of current perception threshold in general populationThe comparison inside the groups: There were no significant difference between the results of CPT in LMF and RMF ((P>0.05). Compared with LMF, there were significant differences in LFA, LBA, RFA and RBA (P<0.05). The results were higher in the four groups.The comparison between the groups: Compared with group ?, the results of CPT in six parts of group ? and group ? were significantly different (P<0.05 ). The CPT of both group ? and group ?were higher than that of group. Compared with group ?, CPT in group ? was significantly higher (P<0.05).Conclusion1. Pain Vision could be used to quantitative evaluation of both persistent pain and breakthrough pain. The pain degree is quantified by PainVision. It provides a more effective and accurate method for the measurement of breakthrough pain.2. The measurements of chronic pain by PainVision show positive correlation with VAS in both persistent pain and breakthrough pain.3. PainVision shows great advantages in quantitative analysis of the functions of sensory nerve.4. The current perception threshold varies both different ages and body parts.CPT of lower limb is significantly higher than that of upper limb. The upper limb is the most sensitive point for the assessment of current perception threshold. |
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