A Study on the Effects of Pain Stimulus on the Blood Pressure and Heart Rate of Undergraduate Medical Students - A Randomized Control Trial
[1]
Varsha Valery A/P Parameswaran, Faculty of Medicine, Melaka Manipal Medical College (Manipal Academy of Higher Education), Melaka, Malaysia.
[2]
Jayaprisshna A/P V. R. Soma Sundaram, Faculty of Medicine, Melaka Manipal Medical College (Manipal Academy of Higher Education), Melaka, Malaysia.
[3]
Aillilkumaran A/L Rajendran, Faculty of Medicine, Melaka Manipal Medical College (Manipal Academy of Higher Education), Melaka, Malaysia.
[4]
Vikneshilan Isaac Ganesh, Faculty of Medicine, Melaka Manipal Medical College (Manipal Academy of Higher Education), Melaka, Malaysia.
[5]
Yau Kim Boon, Faculty of Medicine, Melaka Manipal Medical College (Manipal Academy of Higher Education), Melaka, Malaysia.
The objective of this study was to investigate the effect of pain stimulus on blood pressure and heart rate amongst students in Melaka Manipal Medical College, Muar campus. In this randomized-controlled trial study, 60 volunteers were randomized to Group A (intervention) and Group B (control) groups with sample size of 30 each. A questionnaire was given before the intervention to determine their androgyny and to screen for smoking and hypertension. Their systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) were assessed before any intervention. Participants were then admistered their respective intervention and their SBP, DBP, HR and Pain Score were assessed after 10 seconds and 30 seconds. Their anxiety was assessed after 30 seconds. Unpaired t-test was used to compare mean of both groups and paired t-test was used to compare the before and after of each variable. Our results showed that there were significant systolic blood pressure, pain score and anxiety results in group A compared to group B. However, there are no other significant differences in result between Group A and Group B. The results were analysed by Epi Info Version 7 and GraphPad software to calculate Unpaired t-test, Paired t-test and Chi-Square test. The conclusion is that this study shows that there was some relation between the cold pressor test causing pain and the participants systolic blood pressure after 30 seconds, pain score and anxiety. However, there was no relation between the pain stimulus and participants diastolic blood pressure and heart rate.
[1]
Taxonomy., I. Associatio, Bogduk, N., Merskey, H., 1994. Classification of chronic pain: descriptions of chronic pain syndromes and definitions of pain terms, 2nd ed. IASP Press, Seattle.
[2]
Wood DL, Sheps SG, Elveback LR, Schirger A, Cold pressor test as a predictor of hypertension, Am. Heart J., 6, 1984, 301-306
[3]
Garg S, Kumar A and Singh KD, Blood pressure response to Cold pressor Test in the children of hypertensives, Online J. Health Allied Scs., 9 (1), 2010, 7.
[4]
Silverthorn DU, Michael J. Cold stress and the cold pressor test. Adv Physiol Educ. 2013; 37 (1): 93–96. DOI: 10.1152/advan.00002.2013.
[5]
Von Baeyer CL, Piira T, Chambers CT, Trapanotto M, Zeltzer LK. Guidelines for the cold pressor task as an experimental pain stimulus for use with children. J Pain. 2005; 6 (4): 218–227.
[6]
Northcote RJ, Cooke MB. How useful are the cold pressor test and sustained isometric handgrip exercise with radionuclide ventriculography in the evaluation of patients with coronary artery disease? Br Heart J. 1987; 57 (4): 319–328
[7]
Wirch JL, Wolfe LA, Weissgerber TL, Davies GAL. Cold pressor test protocol to evaluate cardiac autonomic function. Appl Physiol Nutr Metab. 2006; 31 (3): 235–243.
[8]
Nitenberg A, Valensi P, Sachs R, Cosson E, Attali JR, Antony I. Prognostic value of epicardial coronary artery constriction to the cold pressor test in type 2 diabetic patients with angiographically normal coronary arteries and no other major coronary risk factors. Diabetes Care. 2004; 27 (1): 208–215.
[9]
Ishitake T, Kihara T and Matoba T, A revised cold water immersion test for assessing peripheral circulatory function, Kurume Med. J., 43 (1), 1996, 11-5
[10]
Ishitake T, Nakagawa K, Iwamoto J, Mori C and Matoba T, A 4 degrees C-1 min method of cold water immersion test for peripheral circulatory function in fingers, Sangyo Igaku., 34 (6), 1992, 560-4.
[11]
LeBlanc J, Dulac S, Cote J and Girard B, Autonomic nervous system and adaptation to cold in man, J. Appl. Physiol., 39, 1975, 181–186.
[12]
Riley III JL, Robinson ME, Wise EA, Myers CD, Fillingim RB. Sex differences in the perception of noxious experimental stimuli: a meta-analysis. Pain 1998; 74: 181–7.
[13]
Fillingim RB, Maixner W. Gender differences in the responses to noxious stimuli. Pain Forum 1995; 4: 209–21.
[14]
Fillingim RB: Sex, gender, and pain: A biopsychosocial framework, in Fillingim RB (ed): Sex, Gender, and Pain: Progress in Pain Research and Management, vol 17. Seattle, WA: IASP Press, 2000, p 1-6
[15]
Berkley KJ. Sex differences in pain. Behav Brain Sci 1997; 20: 371–80.
[16]
Bruehl S, Carlson CR, McCubbin JA. The relationship between pain sensitivity and blood pressure in normotensives. Pain 1992; 48: 463–7.
[17]
Fillingim RB, Maixner W. The influence of resting blood pressure and gender on pain responses. Psychosom Med 1996; 58: 326–32.
[18]
Bragdon EE, Light KC, Girdler SS, Maixner W. Blood pressure, gender, and parental hypertension are factors in baseline and poststress pain sensitivity in normotensive adults. Inter J Behav Med 1997; 4: 17–38.
[19]
Ghione S. Hypertension-associated hypoalgesia: evidence in experimental animals and humans, pathophysiological mechanisms, and potential clinical consequences. Hypertension 1996; 28: 494–504.
[20]
Sheffield D, Krittayaphong R, Go BM, Christy CG, Biles PL, Sheps DS. The relationship between resting systolic blood pressure and cutaneous pain perception in cardiac patients with angina pectoris and controls. Pain 1997; 71: 249–55.
[21]
France CR. Decreased pain perception and risk for hypertension: considering a common physiological mechanism. Psychophysiology 1999; 36: 683–92.
[22]
Ghione S. Hypertension-associated hypoalgesia: evidence in experimental animals and humans, pathophysiological mechanisms, and potential clinical consequences. Hypertension 1996; 28: 494–504.
[23]
France CR. Decreased pain perception and risk for hypertension: considering a common physiological mechanism. Psychophysiology 1999; 36: 683–92.
[24]
Nyklíc˘ek I. Hypertension and appraisal of aversive stimuli. Brabant, The Netherlands: Katholieke Universiteit; 1997.
[25]
Guyton A, Hall J, Schmitt W, Gruliow R, Norwitz A. Textbook of Medical Physiology. (Vol. 10). Sydney: W. B. Saunders Company; (1956)
[26]
https://www.psytoolkit.org/survey-library/sex-role-bem.html#_introduction
