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Continuous assessment of labour pain using handgrip force.

Wickboldt N, Savoldelli G, Rehberg-Klug B - Pain Res Manag (2015 May-Jun)

Bottom Line: All dynamometer-registered readings were also registered by the external tocogram.All contractions recorded by external tocogram were also registered by the dynamometer.The feedback of intensity and duration of pain could optimize patient-controlled remifentantil application for obstetric analgesia and other situations of highly variable pain intensity.

View Article: PubMed Central - PubMed

ABSTRACT

Background: Assessment of dynamic changes in painful experiences, such as labour, using conventional rating scales (eg, numerical rating scale [NRS]) has limitations. An alternative for continuous pain evaluation could be a signal generated by voluntary action of the parturient. Remifentanil administration for obstetric analgesia could be improved by these dynamic measures of labour pain. In the present study, handgrip force was measured by a dynamometer to signal labour pain.

Objectives: To evaluate: whether continuous monitoring of labour pain using handgrip force allows for determination of pain measurement during contractions; and the correlation between handgrip force and pain intensity on NRS.

Methods: The present observational, single-centre study included 43 parturients. After calibration of the dynamometer for individual hand muscle strength, pain was recorded during early and late labour using a dynamometer and an NRS. The primary end point was the correlation coefficient between NRS ratings and peak intensity recorded by the dynamometer.

Results: All dynamometer-registered readings were also registered by the external tocogram. All contractions recorded by external tocogram were also registered by the dynamometer. Handgrip force was moderately correlated with pain scores on the NRS. Mean handgrip force during contractions had the highest correlation coefficient (Pearson's r=0.67) compared with peak handgrip force (r=0.56) and area under the curve of handgrip force (r=0.55).

Conclusions: Pain intensity and duration can be assessed continuously using handgrip force measured via a dynamometer. The feedback of intensity and duration of pain could optimize patient-controlled remifentantil application for obstetric analgesia and other situations of highly variable pain intensity.

No MeSH data available.


Related in: MedlinePlus

Original tracings of the handheld dynamometer (solid line; in N) and corresponding tocogram (dotted line) for three exemplary parturients (pat 06, 18 and 38) (1A–C)
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f1-prm-20-159: Original tracings of the handheld dynamometer (solid line; in N) and corresponding tocogram (dotted line) for three exemplary parturients (pat 06, 18 and 38) (1A–C)

Mentions: An example of one of the original tracings obtained via the dynamometer is presented in Figure 1. All contractions recorded by the dynamometer were also shown on the external tocogram; however, the duration of pain during the contraction was shorter (mean ± SD 34±12 s) than the corresponding time period of raised abdominal wall tension (45±14 s).


Continuous assessment of labour pain using handgrip force.

Wickboldt N, Savoldelli G, Rehberg-Klug B - Pain Res Manag (2015 May-Jun)

Original tracings of the handheld dynamometer (solid line; in N) and corresponding tocogram (dotted line) for three exemplary parturients (pat 06, 18 and 38) (1A–C)
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4447160&req=5

f1-prm-20-159: Original tracings of the handheld dynamometer (solid line; in N) and corresponding tocogram (dotted line) for three exemplary parturients (pat 06, 18 and 38) (1A–C)
Mentions: An example of one of the original tracings obtained via the dynamometer is presented in Figure 1. All contractions recorded by the dynamometer were also shown on the external tocogram; however, the duration of pain during the contraction was shorter (mean ± SD 34±12 s) than the corresponding time period of raised abdominal wall tension (45±14 s).

Bottom Line: All dynamometer-registered readings were also registered by the external tocogram.All contractions recorded by external tocogram were also registered by the dynamometer.The feedback of intensity and duration of pain could optimize patient-controlled remifentantil application for obstetric analgesia and other situations of highly variable pain intensity.

View Article: PubMed Central - PubMed

ABSTRACT

Background: Assessment of dynamic changes in painful experiences, such as labour, using conventional rating scales (eg, numerical rating scale [NRS]) has limitations. An alternative for continuous pain evaluation could be a signal generated by voluntary action of the parturient. Remifentanil administration for obstetric analgesia could be improved by these dynamic measures of labour pain. In the present study, handgrip force was measured by a dynamometer to signal labour pain.

Objectives: To evaluate: whether continuous monitoring of labour pain using handgrip force allows for determination of pain measurement during contractions; and the correlation between handgrip force and pain intensity on NRS.

Methods: The present observational, single-centre study included 43 parturients. After calibration of the dynamometer for individual hand muscle strength, pain was recorded during early and late labour using a dynamometer and an NRS. The primary end point was the correlation coefficient between NRS ratings and peak intensity recorded by the dynamometer.

Results: All dynamometer-registered readings were also registered by the external tocogram. All contractions recorded by external tocogram were also registered by the dynamometer. Handgrip force was moderately correlated with pain scores on the NRS. Mean handgrip force during contractions had the highest correlation coefficient (Pearson's r=0.67) compared with peak handgrip force (r=0.56) and area under the curve of handgrip force (r=0.55).

Conclusions: Pain intensity and duration can be assessed continuously using handgrip force measured via a dynamometer. The feedback of intensity and duration of pain could optimize patient-controlled remifentantil application for obstetric analgesia and other situations of highly variable pain intensity.

No MeSH data available.


Related in: MedlinePlus