Heart Rate Variability Parameters Do Not Correlate with Pain Intensity in Healthy Volunteers

Meeuse, Jan J.; Löwik, Marco S P; Löwik, Sabine A M; Aarden, Eline; Roon, Arie M. van; Gans, Rijk O. B.; Wijhe, Marten van; Lefrandt, Joop D.; Reyners, Anna K.L.

doi:10.1111/pme.12133

Cited by 22 publications

(22 citation statements)

References 33 publications

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“…In humans, heart-related pain is associated with a reduction in HRV, suggesting that cardiac pain shifts the autonomic balance toward the sympathetic dominance (Ruggeri et al, 1996). Similarly, Yap et al (2000) found that the sympathovagal balance shifts toward sympathetic dominance when the HRV is reduced; SDNN is also decreased in humans subjected to pain (Meeuse et al, 2013). In summary, these results suggest that pain is greater during rectal palpation with uterine palpation compared with rectal palpation without uterine palpation in both healthy and metritic cows.…”

Section: Hrv During Rectal Palpation With and Without Uterine Palpationmentioning

confidence: 82%

Assessment of visceral pain associated with metritis in dairy cows

Stojkov

Keyserlingk

Marchant‐Forde

et al. 2015

Journal of Dairy Science

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Metritis is a common disease in dairy cattle, but to our knowledge, no work has assessed pain associated with this disease. Tissue palpation is commonly used to assess pain in human and veterinary medicine. The objective of this study was to evaluate visceral pain responses during rectal palpation, with and without uterine palpation, in healthy cows and in cows diagnosed with metritis. A total of 49 Holstein dairy cows (mean ± standard deviation parity of 2.8±1.8) were subjected to systematic health checks every 3 d after parturition for 21 d, scoring for vaginal discharge (0 to 4); 13 cows showed a discharge score ≥2 during at least 1 health check and were classified as metritic, whereas 29 cows were classified as healthy and showed no sign of this or any other disease (including mastitis and lameness). Back arch and heart rate variability before examination and during palpation were recorded using video and heart rate monitors. Back arch (cm(2)) on the day of diagnosis was greater in metritic versus healthy cows (1,034±72 vs. 612±48cm(2)), and greater during rectal palpation with uterine palpation versus rectal palpation without uterine palpation (869±45 vs. 777±45cm(2)). Heart rate frequency domain analysis showed that the low-frequency portion was higher in cows with metritis versus healthy cows (16.5±1.2 vs. 12.9±1.0). Time domain analysis showed that the standard deviation between normal to normal interbeat intervals and the root mean square of successive differences both decreased during rectal palpation with uterine palpation versus rectal palpation without uterine palpation (1.9±0.1 vs. 2.5±0.1 and 1.3±0.1 vs. 1.7±0.1, respectively). Together, these results indicate that the inflammation associated with metritis is painful, and that the pain response can be detected during rectal palpation with and without uterine palpation. Rectal palpation with uterine palpation appears to be more aversive than rectal palpation without uterine palpation, suggesting that the former should be avoided when possible.

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Section: Hrv During Rectal Palpation With and Without Uterine Palpationmentioning

confidence: 82%

Assessment of visceral pain associated with metritis in dairy cows

Stojkov

Keyserlingk

Marchant‐Forde

et al. 2015

Journal of Dairy Science

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“…Fluctuations in heart rate during breathing cycles (respiratory sinus arrhythmia) have been integrated to improve parameter accuracy . It is thought to be influenced by noxious stimuli, particularly under steady‐state anaesthesia, but translation into non‐anaesthetised patients is contentious, along with the correlation between heart rate variability and pain intensity . Both pre‐clinical studies and recent clinical trials suggest it could be developed in future into an objective pain assessment tool .…”

Section: Resultsmentioning

confidence: 99%

Assessing pain objectively: the use of physiological markers

et al. 2015

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Summary Pain diagnosis and management would benefit from the development of objective markers of nociception and pain. Current research addressing this issue has focused on five main strategies, each with its own advantages and disadvantages. These encompass: (i) monitoring changes in the autonomic nervous system; (ii) biopotentials; (iii) neuroimaging; (iv) biological (bio‐) markers; and (v) composite algorithms. Although each strategy has shown areas of promise, there are currently no validated objective markers of nociception or pain that can be recommended for clinical use. This article introduces the most important developments in the field and highlights shortcomings, with the aim of allowing the reader to make informed decisions about what trends to watch in the future.

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“…While some may argue that nurses are able to discern stress, fear, and other emotional responses to being ill and voiceless through blood pressure, heart rate, and respiratory factors (Vaajoki, Kankkunen, Pietil€ a, & Vehvil€ ainen-Julkunen, 2011) as well as facial cueing (Molony, Kobayashi, Holleran, & Mezy, 2005), it is suspected that these inferences actually may be inaccurate. In a study of 75 healthy subjects during three periods of application of painful stimulus lasting for 2 minutes, Meeuse et al (2013) found that there was no correlation between painful stimulus and heart rate variability. They also noted there were no changes in respiratory rate with the application of painful stimuli.…”

Section: Literature Reviewmentioning

confidence: 98%

“…In a study of 75 healthy subjects during three periods of application of painful stimulus lasting for 2 minutes, Meeuse et al. () found that there was no correlation between painful stimulus and heart rate variability. They also noted there were no changes in respiratory rate with the application of painful stimuli.…”

Section: Literature Reviewmentioning

confidence: 99%