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BJA Advance Access originally published online on February 6, 2004
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British Journal of Anaesthesia, 2004, Vol. 92, No. 4 532-535
© 2004 The Board of Management and Trustees of the British Journal of Anaesthesia

Review Article

Testing of a new pneumatic device to cause pain in humans

H. M. Schubert*,1, I. H. Lorenz2, F. Zschiegner2, C. Kremser3, M. Hohlrieder2, M. Biebl4, C. Kolbitsch2 and P. L. Moser5

1 Department of Trauma Surgery and Sports Medicine, 2 Department of Anaesthesia and Intensive Care Medicine, 3 Department of Magnetic Resonance Imaging, 4 Department of Vascular Surgery and 5 Department of Pathology, University of Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria

*Corresponding author. E-mail: heinrich.schubert@uibk.ac.at

Background. Surgical pain typically combines superficial and deep pain. We wished to generate pain that resembled surgical pain, reliably and reproducibly, in volunteers.

Methods. We constructed a computer-controlled pneumatic device to apply pressure to the anterior tibia. The reproducibility of the pain was tested by rating the pressure that caused pain rated 4–5 on a visual analogue scale (VAS) on days 0, 7, and 24 in 10 volunteers. The effect of remifentanil (0.025, 0.05, 0.075, and 0.1 µg kg–1 min–1) on pain tolerance in another set of volunteers (n=11) was used as an indirect measure of the reliability of pain production.

Results. The pressure needed (0.7 (0.3) to 0.9 (0.4) atm (mean (SD)) to induce pain rated 4–5 (VAS) did not vary, showing long-term reproducibility of the method. When pressure was applied to cause increasing pain in volunteers (n=11) 0.05 µg kg–1 min–1 remifentanil increased pain tolerance by 50%. An approximate doubling of the dose (0.1 µg kg–1 min–1) increased pain tolerance significantly more. The linear logarithmic dose-effect relationship shows that the device causes pain reliably, and this can be reduced with opioid treatment.

Conclusion. This pneumatic device can apply pain reliably and reproducibly.

Br J Anaesth 2004; 92: 532–5


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