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首页> 外文期刊>Pain. >Gut pain reactions in man: an experimental investigation using short and long duration transmucosal electrical stimulation.
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Gut pain reactions in man: an experimental investigation using short and long duration transmucosal electrical stimulation.

机译：人的肠道痛反应：使用短期和长期持续的经粘膜电刺激的实验研究。

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Visceral pain is a substantial, clinical problem but unfortunately few experimental models are available to study this phenomenon in man. In the present study we inserted a stimulation catheter 5-10 cm into the ileo-sigmoidostomy of nine patients. The catheter contained six small, flexible electrodes separated by 4 mm. The gut was stimulated by single burst, repeated burst (five stimuli delivered at 2 Hz), or continuous burst stimuli (4 Hz for 30, 60, 90, and 120 s). The sensation (ST), pain detection (PDT), and pain tolerance (PTT) thresholds to single/repeated burst stimuli were determined. The location/size/sensitivity of referred pain after repeated/continuous stimulation were characterized. The brain potentials to single burst stimuli and to increasing stimulus intensity were measured. ST to single burst stimuli was easy to determine (8 mA) and to reproduce. The patients found it difficult to determine the PDT and PTT to single burst stimuli, however both thresholds were easily determined for repeated burst stimuli. The pain thresholds to single burst stimuli were twice as high as the thresholds to repeated burst stimuli, indicating the importance of central temporal summation for visceral pain. Minor changes in the stimulus location resulted in changes of the referred pain projection site. The words most frequently selected (78%) from the McGill Pain Questionnaire to describe repeated burst stimulations were shooting, pricking, flashing, and boring. The amplitude of the brain potentials increased at increasing stimulus intensity. A stimulus intensity giving an initial pain rating of around 5 on a 0-10 visual analog scale (VAS) was used for continuous stimulation. A general increase of the pain intensity and the area of referred pain was found during this stimulation. It was concluded that electrical stimulation of the human gut provokes pain and especially long sequences of visceral stimuli are adequate to evoke referred pain mimicking pain profiles of pathologic origin.
机译：内脏痛是一个重大的临床问题，但不幸的是，很少有实验模型可用于研究人类的这种现象。在本研究中，我们将9-10例患者的回肠乙状结肠造口术插入5-10 cm的刺激导管。该导管包含六个间隔4毫米的柔性小电极。通过单次爆发，重复爆发（以2 Hz传递5个刺激）或连续爆发刺激（4 Hz持续30、60、90和120 s）刺激肠道。确定对单个/重复爆发刺激的感觉（ST），疼痛检测（PDT）和疼痛耐受性（PTT）阈值。表征了重复/连续刺激后所引起的疼痛的位置/大小/敏感性。测量了单次爆发刺激和增加刺激强度的脑电势。 ST对单脉冲刺激很容易确定（8 mA）并易于复制。患者发现很难确定单次爆发刺激的PDT和PTT，但是很容易确定重复发作的两个阈值。单次爆发刺激的疼痛阈值是重复爆发刺激的阈值的两倍，这表明中央时间总和对于内脏痛的重要性。刺激位置的微小变化导致所提及的疼痛投射部位的变化。麦吉尔疼痛问卷中最常选择的词（78％）用来描述反复爆发的刺激是射击，刺痛，闪烁和无聊。脑电势的振幅随着刺激强度的增加而增加。在0-10视觉模拟量表（VAS）上给出初始疼痛等级约为5的刺激强度用于连续刺激。在此刺激过程中，疼痛强度和所指疼痛区域普遍增加。结论是，对人体肠道的电刺激会引起疼痛，尤其是较长的内脏刺激序列足以引起模仿病理起源的疼痛特征的参考疼痛。

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