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

我们研究的最终目标是建立一种方法来确认没有疼痛主诉的住院患者的疼痛缓解。为了实现这一目标，我们在此证实了小波分析心电电压波动作为癌症住院患者疼痛客观评估方法的可行性。在这项初步研究中，8名癌症疼痛住院患者接受了使用视觉模拟评分(VAS)或数字分级评分(NRS)对疼痛的主观评估，随后进行了包括分析心电图电压波动的客观评估。特别是，评估了客观方法是否可以有效地辅助诊断疼痛的程度。在所有8例无运动伪影的癌症住院患者中，心电图电压波动的功率幅度与同期疼痛的VAS或NRS评分相关。此外，在5名没有运动伪影的患者中，在给予救援量的阿片类药物后，这些波动的功率幅度、VAS评分和NRS评分显著降低。心电电压波动的功率谱分析是一种很有前途的评估癌症住院患者疼痛程度的方法。

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.