BACKGROUND: Autonomic arousal frequently is assumed to be a component of the pain response, perhaps because physiological mechanisms connecting pain and autonomic reactivity can be easily conceptualized. The evidence clarifying autonomic responses specific to painful stimulation, however, has been rather sporadic and lacks coherence; thus, a summary and critical review is needed in this area.OBJECTIVES: To summarize and integrate findings from 39 experimental investigations from 1970 to 2012 of pain-induced autonomic arousal in humans.METHODS: Medline and PsycINFO databases were searched for relevant articles. References from these articles were also considered for review.RESULTS: Painful stimuli increase respiration rate, induce muscle tension, intensify electrodermal activity and dilate the pupils. Cardiovascular activity also increases, but the pattern displayed in response to pain is complex; peripheral vasoconstriction and sympathetically mediated cardiac responses are most typical. Additionally, autonomic expression of pain shows inconsistent relations with verbal and overt motor responses.CONCLUSIONS: Autonomic arousal can be legitimately measured and modified as one facet of the pain response. Future research should particularly focus on increasing sample size and broadening the diversity of participants. To improve the ability to compare and contrast findings across studies, as well as to increase the applicability of laboratory findings to naturalistic pain, investigators also must enhance experimental design by increasing uniformity or accounting for differences in methodology. Finally, further work remains to utilize more specific assessments of autonomic response and to assess relationships of autonomic reactivity with other cognitive (eg, attention) and affective (eg, anxiety) variables.

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自主性引起的和实验性引起的疼痛：对文献的评论

背景：自主性兴奋经常被认为是疼痛反应的一部分，也许是因为可以很容易地概念化连接疼痛和自主性反应的生理机制。但是，澄清特定于疼痛刺激的自主神经反应的证据相当零星，缺乏连贯性。目的：总结和整合1970年至2012年间39项关于人类疼痛引起的自主神经唤醒的实验研究的结果。方法：在Medline和PsycINFO数据库中搜索相关文章。结果：痛苦的刺激会增加呼吸频率，引起肌肉紧张，加剧皮肤电活动，并使瞳孔扩大。心血管活动也增加，但是响应疼痛而显示的模式很复杂；最典型的是外周血管收缩和交感神经介导的心脏反应。此外，疼痛的自主表达与言语和明显的运动反应之间存在不一致的关系。结论：自主觉醒可以作为疼痛反应的一个方面被合理地测量和修改。未来的研究应特别关注增加样本量和扩大参与者的多样性。为了提高跨研究比较和对比结果的能力，以及增加实验室发现对自然性疼痛的适用性，研究人员还必须通过增加统一性或解决方法差异来增强实验设计。最后，