Dolorimeter
Encyclopedia
A dolorimeter is an instrument used to measure pain threshold and pain tolerance
. Dolorimetry has been defined as "the measurement of pain sensitivity or pain intensity." There are several kinds of dolorimeter that have been developed. Dolorimeters apply steady pressure, heat, or electrical stimulation to some area, or move a joint or other body part and determine what level of heat or pressure or electric current or amount of movement produces a sensation of pain
. Sometimes the pressure is applied using a blunt object, or by locally increasing the air pressure on some area of the body, and sometimes by pressing a sharp instrument against the body.
introduced the first dolorimeter as a method for evaluating the effectiveness of analgesic medications. They did their work at New York Hospital
. They focused the light of a 100 watt projection lamp with a lens on an area of skin that had been blackened. They found that most people expressed a pain sensation when the skin temperature reached 113 °F (45 °C). They also found that after the skin temperature reached 152 °F (67 °C), the pain sensations did not intensify even if the heat was increased. They developed a pain scale, called the "Hardy-Wolff-Goodell" scale, with 10 gradations, or 10 levels. They assigned the name of "dols" to these levels. Unfortunately, other researchers were not able to reproduce the results of Hardy, Wolff and Goodell and the device and the approach was abandoned. Harvard Medical School
Professor and Massachusetts General Hospital
Anaesthetist Henry K. Beecher
(1957) expressed skepticism about this method of measuring pain.
In 1945, Time Magazine reported that Cleveland's Dr. Lorand Julius Bela Gluzek had developed a dolorimeter that measured pain in grams. Dr. Gluzek claimed that his dolorimeter was 97% accurate.
in British Columbia
, Canada
. Patents have been applied for worldwide. The Sonic Palpometer uses ultrasound and computer technology to automate the physician's technique of palpation
to determine sensitivity of some part of the patient's body.
The related pressure controlled palpometer (PCP) uses a pressure-sensitive piece of plastic film to determine how much pressure is being applied in palpation. This technique appears to be more reliable than unaided palpation.
A laser-based dolorimeter called a Dolorimeter Analgesia meter is marketed by IITC Life Sciences.
which is delivered to a small area of skin
.
Other terms for similar instruments include algesiometer, algesichronometer (which also takes time into consideration), analgesia meter, algometer, algonometer, prick-algesimeter, pressure-algometer.
Pain tolerance
Pain tolerance is the maximum level of pain that a person is able to tolerate. Pain tolerance is distinct from pain threshold .-Factors affecting pain tolerance:...
. Dolorimetry has been defined as "the measurement of pain sensitivity or pain intensity." There are several kinds of dolorimeter that have been developed. Dolorimeters apply steady pressure, heat, or electrical stimulation to some area, or move a joint or other body part and determine what level of heat or pressure or electric current or amount of movement produces a sensation of pain
Pain
Pain is an unpleasant sensation often caused by intense or damaging stimuli such as stubbing a toe, burning a finger, putting iodine on a cut, and bumping the "funny bone."...
. Sometimes the pressure is applied using a blunt object, or by locally increasing the air pressure on some area of the body, and sometimes by pressing a sharp instrument against the body.
History
In 1940, James D. Hardy, Harold G. Wolff and Helen Goodell of Cornell UniversityCornell University
Cornell University is an Ivy League university located in Ithaca, New York, United States. It is a private land-grant university, receiving annual funding from the State of New York for certain educational missions...
introduced the first dolorimeter as a method for evaluating the effectiveness of analgesic medications. They did their work at New York Hospital
New York Hospital
New York Hospital or “Old New York Hospital” or “City Hospital” was the oldest hospital in New York City and the second oldest hospital in the United States.-Early History:...
. They focused the light of a 100 watt projection lamp with a lens on an area of skin that had been blackened. They found that most people expressed a pain sensation when the skin temperature reached 113 °F (45 °C). They also found that after the skin temperature reached 152 °F (67 °C), the pain sensations did not intensify even if the heat was increased. They developed a pain scale, called the "Hardy-Wolff-Goodell" scale, with 10 gradations, or 10 levels. They assigned the name of "dols" to these levels. Unfortunately, other researchers were not able to reproduce the results of Hardy, Wolff and Goodell and the device and the approach was abandoned. Harvard Medical School
Harvard Medical School
Harvard Medical School is the graduate medical school of Harvard University. It is located in the Longwood Medical Area of the Mission Hill neighborhood of Boston, Massachusetts....
Professor and Massachusetts General Hospital
Massachusetts General Hospital
Massachusetts General Hospital is a teaching hospital and biomedical research facility in the West End neighborhood of Boston, Massachusetts...
Anaesthetist Henry K. Beecher
Henry K. Beecher
Henry Knowles Beecher was an important figure in the history of anesthesiology and medicine, receiving awards and honors during his career. His 1966 article on unethical practices in medical experimentation within the New England Journal of Medicine was instrumental in the implementation of...
(1957) expressed skepticism about this method of measuring pain.
In 1945, Time Magazine reported that Cleveland's Dr. Lorand Julius Bela Gluzek had developed a dolorimeter that measured pain in grams. Dr. Gluzek claimed that his dolorimeter was 97% accurate.
Palpometer
A dolorimeter known as the Sonic Palpometer was developed at the University of VictoriaUniversity of Victoria
The University of Victoria, often referred to as UVic, is the second oldest public research university in British Columbia, Canada. It is a research intensive university located in Saanich and Oak Bay, about northeast of downtown Victoria. The University's annual enrollment is about 20,000 students...
in British Columbia
British Columbia
British Columbia is the westernmost of Canada's provinces and is known for its natural beauty, as reflected in its Latin motto, Splendor sine occasu . Its name was chosen by Queen Victoria in 1858...
, Canada
Canada
Canada is a North American country consisting of ten provinces and three territories. Located in the northern part of the continent, it extends from the Atlantic Ocean in the east to the Pacific Ocean in the west, and northward into the Arctic Ocean...
. Patents have been applied for worldwide. The Sonic Palpometer uses ultrasound and computer technology to automate the physician's technique of palpation
Palpation
Palpation is used as part of a physical examination in which an object is felt to determine its size, shape, firmness, or location...
to determine sensitivity of some part of the patient's body.
The related pressure controlled palpometer (PCP) uses a pressure-sensitive piece of plastic film to determine how much pressure is being applied in palpation. This technique appears to be more reliable than unaided palpation.
Techniques using lasers
Svensson et al. (1997) describe the use of a CO2 laser or a contact thermode to heat the skin and elicit a pain response.A laser-based dolorimeter called a Dolorimeter Analgesia meter is marketed by IITC Life Sciences.
Techniques using heat lamps
Another pain measurement device uses heat from a 500 watt lampIncandescent light bulb
The incandescent light bulb, incandescent lamp or incandescent light globe makes light by heating a metal filament wire to a high temperature until it glows. The hot filament is protected from air by a glass bulb that is filled with inert gas or evacuated. In a halogen lamp, a chemical process...
which is delivered to a small area of skin
Skin
-Dermis:The dermis is the layer of skin beneath the epidermis that consists of connective tissue and cushions the body from stress and strain. The dermis is tightly connected to the epidermis by a basement membrane. It also harbors many Mechanoreceptors that provide the sense of touch and heat...
.
Other dolorimeters
- Baseline Algorimeter from the Kom Kare Company.
- Björnström's algesimeter measures sensitivity of the skin to pain.
- Boas' algesimeter measures sensitivity over the epigastriumEpigastriumThe epigastrium is the upper central region of the abdomen. It is located between the costal margins and the subcostal plane....
Other terms for similar instruments include algesiometer, algesichronometer (which also takes time into consideration), analgesia meter, algometer, algonometer, prick-algesimeter, pressure-algometer.
Dolorimetry for animals
Dolorimetry in animals involves application of pain to various body parts. It is occasionally used as a diagnostic tool, and routinely used in basic pain research and in the testing of analgetics.See also
- Pain scalePain scaleA pain scale measures a patient's pain intensity or other features. Pain scales are based on self-report, observational , or physiological data. Self-report is considered primary and should be obtained if possible. Pain scales are available for neonates, infants, children, adolescents, adults,...
- Dol
- Pain tolerancePain tolerancePain tolerance is the maximum level of pain that a person is able to tolerate. Pain tolerance is distinct from pain threshold .-Factors affecting pain tolerance:...
- Pain threshold
- Schmidt Sting Pain IndexSchmidt Sting Pain IndexThe Schmidt Sting Pain Index is a pain scale rating the relative pain caused by different Hymenopteran stings. It is mainly the work of Justin O. Schmidt, an entomologist at the Carl Hayden Bee Research Center in Arizona...