What is the clinical evidence from this study?

Study design: Observational. Population: Chronic lower back or leg pain (n=16). Intervention: Substantial pain relief vs. Little pain relief. Primary outcome: Increase in PD2 measure of heart rate variability by ≥5%.

August 1, 1999Anesthesia & Analgesia

Relief of Chronic Pain May Be Accompanied by an Increase in a Measure of Heart Rate Variability

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Key result

Substantial acute relief of chronic pain was associated with a ≥5% increase in the PD2 measure of heart rate variability in 77.8% of patients compared to 28.6% of controls.

Why the study?

Does acute relief of chronic pain improve heart rate variability in patients with nerve root compression?

Population

16 patients with lower back or leg pain for 3 months to 1 year, with history and physical examination…

Comparison

Substantial pain relief following caudal… vs Little pain relief following the same caudal…

Design

Cohort

Follow-up

Acute (just before and after treatment)

Authors

RSR. J. StorellaAllegheny College YSYue ShiNanjing Drum Tower Hospital DODaniel O’ConnorTwitter (United States)

Discussion

Member takes

Implication

Acute pain relief was associated with PD2 rise; hypothesis-generating for objective pain assessment, needs prospective validation.

Study Design

Type

Observational (n=16)

Structured PICO

Does acute relief of chronic pain improve heart rate variability in patients with nerve root compression?

Population

16 patients with chronic lower back or leg pain due to a herniated disk, evaluated for heart rate variability before and after a caudal epidural injection.

Exposure

Substantial pain relief (≥50% decrease in pain scale) following caudal epidural injection of 5 mL of 0.25% bupivacaine and 80 mg methylprednisolone.

Comparator

Little pain relief following the same caudal epidural injection.

Outcome

Change in heart rate variability measures (PD2, mean RR interval, SD, ApEn) measured just before and after treatment.surrogate

Main Result

Absolute Event Rate: 77.8% vs 28.6%

Acute relief of chronic pain is accompanied by an increase in the PD2 measure of heart rate variability, suggesting its potential as an objective adjunct for pain assessment.

Limitations

Small scope of the investigation limits the power of the analysis to detect significant effects on various HRV measures.
Limited ability to generalize the findings to the wide variety of patients with chronic pain.
Small sample size limits the power of the analysis
Limited ability to generalize findings to a wide variety of patients with chronic pain

Cite This Study

Storella et al. (1999) conducted an observational in Chronic lower back or leg pain (n=16). Substantial pain relief vs. Little pain relief was evaluated on Increase in PD2 measure of heart rate variability by ≥5%. Substantial acute relief of chronic pain was associated with a ≥5% increase in the PD2 measure of heart rate variability in 77.8% of patients compared to 28.6% of controls.

synapsesocial.com/papers/6a930cc1c0b3311637eb4810 https://doi.org/10.1213/00000539-199908000-00037

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Relief of Chronic Pain May Be Accompanied by an Increase in a Measure of Heart Rate Variability

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Relief of Chronic Pain May Be Accompanied by an Increase in a Measure of Heart Rate Variability

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Also Consider