ابو فيصل99
05/09/03, 08 :06 08:06:45 AM
Pain scales are a well-accepted tool in the evaluation of pain and provide an accurate description of perceived level of pain. The question under study here is the accuracy of that perception. Utilizing a small convenience sample consisting of healthy, adult, emergency department staff, this study is an attempt to document the accuracy of an individual's perception of varying pain stimuli.
Participants were asked to avoid alcohol, caffeine, and analgesics prior to the study. Pain was applied using varying levels of electrical shock via a pediatric EKG electrode applied to the arm. The investigator administered a series of shocks of increasing intensity until the subject reported that the pain was "intolerable." After that report, the investigator continued to apply shocks of the same intensity and the participant was asked to report if the pain was less, the same, or more. The testing was stopped for each individual when he/she reported 3 shocks in a row as "the same."
As would be expected, the nerve stimulator setting that an individual reported as "intolerable" varied greatly, from a low of 4 to a maximum of 9. There was poor correlation between the amount of stimulus applied and the perception of intolerable pain. Once the threshold was reached, only 95 of 185 subsequent shocks were perceived as the same, even though the stimulus was identical.
Editor's Comment: This small study highlights the variability of patient perception of pain. It also illustrates the fact that the same pain intensity may be perceived differently on different occasions. The authors suggest that the study points to the need for research aimed at development of pain tools that do not rely exclusively on patient perception. Pain is a uniquely individual phenomenon and to attempt to remove that individuality from the management of pain seems unlikely to be successful. Better yet, we all need to be reminded that a patient's pain is only theirs, and should be managed in a way that is best for that individual.
Participants were asked to avoid alcohol, caffeine, and analgesics prior to the study. Pain was applied using varying levels of electrical shock via a pediatric EKG electrode applied to the arm. The investigator administered a series of shocks of increasing intensity until the subject reported that the pain was "intolerable." After that report, the investigator continued to apply shocks of the same intensity and the participant was asked to report if the pain was less, the same, or more. The testing was stopped for each individual when he/she reported 3 shocks in a row as "the same."
As would be expected, the nerve stimulator setting that an individual reported as "intolerable" varied greatly, from a low of 4 to a maximum of 9. There was poor correlation between the amount of stimulus applied and the perception of intolerable pain. Once the threshold was reached, only 95 of 185 subsequent shocks were perceived as the same, even though the stimulus was identical.
Editor's Comment: This small study highlights the variability of patient perception of pain. It also illustrates the fact that the same pain intensity may be perceived differently on different occasions. The authors suggest that the study points to the need for research aimed at development of pain tools that do not rely exclusively on patient perception. Pain is a uniquely individual phenomenon and to attempt to remove that individuality from the management of pain seems unlikely to be successful. Better yet, we all need to be reminded that a patient's pain is only theirs, and should be managed in a way that is best for that individual.