Hypercapnia Reduces Perceived Heat Pain in Healthy Subjects

IF 3.5 2区 医学 Q1 ANESTHESIOLOGY
A. Guekos, M. Hau, S. Grob, G. Sharvit, P. Schweinhardt
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引用次数: 0

Abstract

Background

Danger signals modulate pain perception. Both amplification and attenuation of perceived pain are observed in healthy subjects exposed to danger signals, such as transient threats of an imminent electrical shock. However, exposure to danger signals in real life typically is not transient but constant over minutes to hours. Here, this was experimentally achieved by administering hypercapnic air (7.5% CO2). The primary objective was to investigate whether perceived heat pain would be differentially modulated during this intervention compared to regular air administration. The secondary objective assessed the potential differences of such a modulation with respect to heat intensity level.

Methods

Thirty-eight participants (19 women) received two air mixtures (hypercapnic and regular air) for 13 min each, during which 18 (6 × 3) noxious heat stimuli of three different intensities were applied to the calf and rated on two scales (intensity and pleasantness/unpleasantness). Psychological and physiological states were compared between conditions using the body sensations questionnaire, self-assessment manikins, heart rate, and galvanic skin response. Statistical analyses were performed using Bayesian estimation testing.

Results

Between-condition differences were statistically meaningful for all heat intensity levels, always showing reduced pain perception during hypercapnia compared to normocapnia. The magnitude of the observed hypoalgesia did not depend on heat intensity levels.

Conclusions

The presence of a continuous physiological danger signal results in hypoalgesia. Future studies need to determine whether the present results only hold for hypercapnia in healthy subjects or are generalisable to interactions between pain perception and continuous physiological danger signals in clinical pain populations.

Significance Statement

It was shown that hypercapnia leads to reduced perception of noxious heat stimuli. If confirmed by neural data in future studies this could help to better understand the interaction of pain perception and continuous physiological danger signals in clinical pain conditions, potentially allowing for improved treatment of affected individuals.

Abstract Image

高碳酸血症可降低健康受试者的热痛感知
危险信号调节疼痛感知。在暴露于危险信号(如即将发生的电击的短暂威胁)的健康受试者中,可以观察到感知疼痛的放大和衰减。然而,在现实生活中,暴露于危险信号通常不是短暂的,而是持续几分钟到几小时。在这里,这是通过施用高碳酸空气(7.5% CO2)实验实现的。主要目的是调查与常规空气管理相比,这种干预是否会对感知到的热痛进行差异调节。次要目标评估了这种调制相对于热强度水平的潜在差异。方法38名受试者(19名女性)分别接受高碳酸空气和普通空气两种混合空气,每种混合空气持续13 min,对小腿施加3种不同强度的18 (6 × 3)次有害热刺激,并按强度和愉快/不愉快程度进行评分。使用身体感觉问卷、自我评估模型、心率和皮肤电反应对不同条件下的心理和生理状态进行比较。统计分析采用贝叶斯估计检验。结果所有热强度水平的条件间差异均有统计学意义,高碳酸血症期间的疼痛感觉总是比正常碳酸血症期间的疼痛感觉减少。观察到的痛觉减退的程度与热强度水平无关。结论持续存在的生理危险信号导致痛觉减退。未来的研究需要确定目前的结果是否只适用于健康受试者的高碳酸血症,还是可以推广到临床疼痛人群中疼痛感知和持续生理危险信号之间的相互作用。研究表明,高碳酸血症导致对有害热刺激的感知降低。如果在未来的研究中得到神经数据的证实,这将有助于更好地理解临床疼痛条件下疼痛感知和持续生理危险信号的相互作用,从而有可能改善受影响个体的治疗。
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来源期刊
European Journal of Pain
European Journal of Pain 医学-临床神经学
CiteScore
7.50
自引率
5.60%
发文量
163
审稿时长
4-8 weeks
期刊介绍: European Journal of Pain (EJP) publishes clinical and basic science research papers relevant to all aspects of pain and its management, including specialties such as anaesthesia, dentistry, neurology and neurosurgery, orthopaedics, palliative care, pharmacology, physiology, psychiatry, psychology and rehabilitation; socio-economic aspects of pain are also covered. Regular sections in the journal are as follows: • Editorials and Commentaries • Position Papers and Guidelines • Reviews • Original Articles • Letters • Bookshelf The journal particularly welcomes clinical trials, which are published on an occasional basis. Research articles are published under the following subject headings: • Neurobiology • Neurology • Experimental Pharmacology • Clinical Pharmacology • Psychology • Behavioural Therapy • Epidemiology • Cancer Pain • Acute Pain • Clinical Trials.
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