Objective evaluation of pain in cancer inpatients not complaining of cancer pain

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The ultimate goal of our research is to establish a method to confirm pain relief in inpatients who do not complain of pain. Towards this goal, here we confirmed the feasibility of wavelet analysis of ECG voltage fluctuation as an objective evaluation method of pain in cancer inpatients who did complain of pain. In this pilot study, 8 inpatients with cancer pain underwent a subjective evaluation of pain using a visual analogue scale(VAS) or numerical rating scale(NRS) and subsequently an objective evaluation involving analysis of ECG voltage fluctuations. In particular, it was evaluated whether the objective method could be an effective aid in the diagnosis of the degree of pain. The power amplitudes of ECG voltage fluctuations were found to be correlated with VAS or NRS scores in the same period with pain in all 8 cancer inpatients without motion artifacts. Moreover, the power amplitudes of these fluctuations, VAS score, and NRS score were significantly reduced after administration of a rescue dose of opioid in 5 of the patients without motion artifacts. Power spectral analysis of ECG voltage fluctuations is a promising method to evaluate the degree of pain in cancer inpatients.