Electroencephalogram-derived pain index for evaluating pain during labor

Abstract

Background The discriminative ability of a point-of-care electroencephalogram (EEG)-derived pain index (Pi) for objectively assessing pain has been validated in chronic pain patients. The current study aimed to determine its feasibility in assessing labor pain in an obstetric setting. Methods Parturients were enrolled from the delivery room at the department of obstetrics in a tertiary hospital between February and June of 2018. Pi values and relevant numerical rating scale (NRS) scores were collected at different stages of labor in the presence or absence of epidural analgesia. The correlation between Pi values and NRS scores was analyzed using the Pearson correlation analysis. The receiver operating characteristic (ROC) curve was plotted to estimate the discriminative capability of Pi to detect labor pain in parturients. Results Eighty paturients were eligible for inclusion. The Pearson correlation analysis exhibited a positive correlation between Pi values and NRS scores in parturients (r = 0.768, P < 0.001). The ROC analysis revealed a cut-off Pi value of 18.37 to discriminate between mild and moderate-to-severe labor pain in parturients. Further analysis indicated that Pi values had the best diagnostic accuracy reflected by the highest area under the curve (AUC) of 0.857, with a sensitivity and specificity of 0.767 and 0.833, respectively, and a Youden index of 0.6. Subgroup analyses further substantiated the correlations between Pi values and NRS scores, especially in parturients with higher pain intensity. Conclusion This study indicates that Pi values derived from EEGs significantly correlate with the NRS scores, and can serve as a way to quantitatively and objectively evaluate labor pain in parturients.

A Novel Preoperative Electroencephalogram-Derived Index to Predict Early Postoperative Delirium in Elderly Patients After Hip Fracture Surgeries: Development of a Prediction Model

“… 11 The development of the DELi score was based on the entire frequency band-EEG wavelet algorithm. 12 , 13 In the presence of delirium, repeatable and regular changes were extracted from brain waves as the characteristic indicators of delirium. 14 The DELi score incorporated these dynamic variations of EEG parameters attributable to delirium based on a wavelet algorithm, 12 , 13 and was thus related to the cognitive status of delirium.…”

“… 11 Recently, the entire frequency band EEG was analyzed by developing a wavelet analysis method. 12 , 13 Based on this wavelet algorithm, a series of specific changes in EEG were identified when delirium occurred. These dynamic variations of EEG parameters attributable to delirium were integrated into a real-time index named the delirium index (DELi ranging from 0-100 and positively associated with the probability of delirium).…”

Tools for assessing labour pain: a comprehensive review of research literature

“…The implementation of the NRS showed similar variability to that of the VAS. Most interesting was the variability that occurred in the 9 studies 3,18,29,37,40,73,83,86,110 that included additional verbal descriptors beneath the tool, in relation to the terms used as well as the numerical values denoted to each (Fig. 3).…”

“…For example, 1 study 37 used the descriptor "severe" for a rating of 10 out of 10, whereas another 18 used that same descriptor for any rating above 5 out of 10. Seven 3,29,37,73,83,86,110 of the 9 studies used the descriptor "nil" for a rating of zero out of 10, whereas 2 studies 18,40 denoted a rating of zero as either "mild" or "low" pain, thereby removing the possibility for the user to indicate no pain.…”

Protocol for Prognosticating PPD Using EEG Changes during Labor Pain by Uterine Contractions: A Prospective Cohort Study in the First Stage of Labor

“…However, the ndings were restricted by a small sample size (n = 10) and absent observations of EEG changes in uterine contraction pain following LEA. Sun et al [13] found that Pain Index (Pi), developed from EEG using two channels, could be utilised as a quantitative and objective measurement of labour pain. However, PI is a general measure that cannot pinpoint which brain regions or electrodes are most responsible for the EEG changes brought by labour pain.…”