Respiratory Effects on Experimental Heat Pain and Cardiac Activity
Respiratory Effects on Experimental Heat Pain and Cardiac Activity
复制标题
DOI：
10.1111/j.1526-4637.2009.00681.x
复制
发表时间：
2009-11-01
期刊：
影响因子：
3.1
通讯作者：
Marchand, Serge
中科院分区：
文献类型：
--
作者：
Chalaye, Philippe;Goffaux, Philippe;Marchand, Serge
Objective.缓慢的深呼吸被认为是减轻疼痛的有效方法。然而，还没有进行实验研究来验证这一说法。我们测量了20名健康成年人在五种不同条件下的热疼痛阈值和耐受性评分，即自然呼吸（基线），缓慢深呼吸（6次呼吸/分钟），快速呼吸（16次呼吸/分钟），分心（视频游戏）和心率（HR）生物反馈。我们从心电图（ECG）输出中测量呼吸（频率和深度）和HR变异性，并使用ECG的时域和频域测量分析呼吸对疼痛和HR变异性的影响。与基线相比，缓慢深呼吸（P = 0.002）、HR生物反馈（P < 0.001）和分心（P = 0.006）期间的热痛阈值显著更高，而缓慢深呼吸（P = 0.003）和HR生物反馈（P < 0.001）期间的热痛耐受性显著更高。与基线相比，只有缓慢深呼吸和HR生物反馈条件对心脏活动有影响。上述条件使迷走神经心肌标志物的振幅（峰谷比，P < 0.001）和低频功率（P < 0.001）增加。缓慢深呼吸和HR生物反馈具有镇痛作用，并增加迷走神经心脏活动。分心也产生镇痛，但是，这些影响并没有伴随着心脏活动的变化。这表明，神经生物学基础的麻醉诱导的镇痛和分心是不同的。临床意义进行了讨论，是可能的心肺过程负责调解呼吸引起的镇痛。
Objective. Slow deep breathing has been proposed as an effective method to decrease pain. However, experimental studies conducted to validate this claim have not been carried out.Design. We measured thermal pain threshold and tolerance scores from 20 healthy adults during five different conditions, namely, during natural breathing (baseline), slow deep breathing (6 breaths/minute), rapid breathing (16 breaths/minute), distraction (video game), and heart rate (HR) biofeedback. We measured respiration (rate and depth) and HR variability from the electrocardiogram (ECG) output and analyzed the effects of respiration on pain and HR variability using time and frequency domain measures of the ECG.Results. Compared with baseline, thermal pain threshold was significantly higher during slow deep breathing (P = 0.002), HR biofeedback (P < 0.001), and distraction (P = 0.006), whereas thermal pain tolerance was significantly higher during slow deep breathing (P = 0.003) and HR biofeedback (P < 0.001). Compared with baseline, only slow deep breathing and HR biofeedback conditions had an effect on cardiac activity. These conditions increased the amplitude of vagal cardiac markers (peak-to-valley, P < 0.001) as well as low frequency power (P < 0.001).Conclusion. Slow deep breathing and HR biofeedback had analgesic effects and increased vagal cardiac activity. Distraction also produced analgesia; however, these effects were not accompanied by concomitant changes in cardiac activity. This suggests that the neurobiology underlying respiratory-induced analgesia and distraction are different. Clinical implications are discussed, as are the possible cardiorespiratory processes responsible for mediating breathing-induced analgesia.