The following is a summary of “Prediction of pain using electrocardiographic-derived autonomic measures: A systematic review,” published in the August 2023 issue of Pain by Wegeberg, et al.

Pain is a clinical challenge. Autonomic dysfunction may predict pain sensation. Researchers performed a retrospective study to investigate the ability of electrocardiographic measures to predict pain.

They reviewed English articles indexed in PubMed and EMBASE to assess their eligibility and included articles that reported the ability of electrocardiographic-derived measures to predict pain response. These articles’ characteristics were considered using the Quality in Prognostic Studies (QUIPS) tool.

The results showed that the search identified 15 publications, five focusing on experimental pain, five on postoperative pain, and five on longitudinal clinical pain changes, with 1,069 patients. Electrocardiographic parameters to predict pain were assessed through pain thresholds using quantitative sensory testing or various scales. Electrocardiographic measures demonstrated predictive capabilities. In most instances, higher parasympathetic activity correlated with reduced experimental, postoperative, and long-term pain, while changes in sympathetic activity did not consistently predict pain.

They concluded parasympathetic activity may be used to predict pain intensity and guide personalized pain management.

Source: onlinelibrary.wiley.com/doi/full/10.1002/ejp.2175