A New Tool for Real-Time Pain Assessment in Experimental and Clinical Environments

Pain measurement largely depends on the ability to rate personal subjective pain. Nevertheless, pain scales can be difficult to use during medical procedures. We hypothesized that pain can be expressed intuitively and in real-time by squeezing a pressure sensitive device. We developed such a device called “Painmouse®” and tested it on healthy volunteers and patients in two separate studies: Sixteen male participants rated different painful heat stimuli via Painmouse® and a Visual Analog Scale (VAS). Retest was done one week later. Participants clearly distinguished four distinct pain levels using both methods. Values from the first and second sessions were comparable. Thereafter, we tested the Painmouse® by asking twelve female and male leg- ulcer patients to continuously squeeze it during the whole length of their wound-dressing change. Patients rated each step of dressing change on an 11-point numeric rating scale. Painmouse® ratings were highest for the wound cleaning and debridement step. Application of the new dressing was not evaluated as very painful. On the other hand, numeric scale ratings did not differentiate between dressing change steps. We conclude that the Painmouse® enables pain assessment even under difficult clinical circumstances, such as during a medical treatment in elderly patients.

疼痛评估在很大程度上依赖于对个体主观疼痛进行量化评分的能力。然而，在临床操作过程中，传统疼痛量表往往难以便捷应用。本研究提出假设：通过握持压力感应装置，可直观且实时地传递疼痛感知。据此，我们研发了一款名为“Painmouse®”的压力感应装置，并通过两项独立研究分别在健康志愿者与患者群体中对其性能进行了测试：第一项研究中，16名男性受试者通过Painmouse®与视觉模拟评分法（Visual Analog Scale, VAS）对不同强度的热痛刺激进行疼痛评分，并于一周后完成复测。结果显示，受试者通过两种方法均能清晰区分4种不同程度的疼痛，且两次测试所得评分具有良好的一致性。后续我们开展了第二项研究：招募12名男女下肢溃疡患者，要求其在整个伤口换药过程中持续握持Painmouse®，同时采用11点数字评分量表对伤口换药的每个步骤进行疼痛评分。Painmouse®的评分结果显示，伤口清洁与清创步骤的疼痛评分最高，而新型敷料的粘贴步骤并未被评定为重度疼痛。反观11点数字评分量表，则未能区分换药各步骤间的疼痛差异。本研究结论表明，即便在复杂临床场景下（如老年患者的诊疗过程中），Painmouse®仍可实现有效的疼痛评估。