The effects of propranolol on heart rate variability and quantitative, mechanistic, pain profiling: a randomized placebo-controlled crossover study

Journal article


Kristian Kjær Petersen, H.H. Andersen, Masato Tsukamoto, Lincoln M. Tracy, Julian Koenig and Lars Arendt-Nielsen. (2018). The effects of propranolol on heart rate variability and quantitative, mechanistic, pain profiling: a randomized placebo-controlled crossover study. Scandinavian Journal of Pain. 18(3), pp. 479-489. https://doi.org/10.1515/sjpain-2018-0054
AuthorsKristian Kjær Petersen, H.H. Andersen, Masato Tsukamoto, Lincoln M. Tracy, Julian Koenig and Lars Arendt-Nielsen
Abstract

The autonomic nervous system (ANS) is capable of modulating pain. Aberrations in heart rate variability (HRV), reflective of ANS activity, are associated with experimental pain sensitivity, chronic pain, and more recently, pain modulatory mechanisms but the underlying mechanisms are still unclear. HRV is lowered during experimental pain as well as in chronic pain conditions and HRV can be increased by propranolol, which is a non-selective β-blocker. Sensitization of central pain pathways have been observed in several chronic pain conditions and human mechanistic pain biomarkers for these central pain pathways include temporal summation of pain (TSP) and conditioned pain modulation (CPM). The current study aimed to investigate the effect of the β-blocker propranolol, and subsequently assessing the response to standardized, quantitative, mechanistic pain biomarkers. In this placebo-controlled, double-blinded, randomized crossover study, 25 healthy male volunteers (mean age 25.6 years) were randomized to receive 40 mg propranolol and 40 mg placebo. Heart rate, blood pressure, and HRV were assessed before and during experimental pain tests. Cuff pressure pain stimulation was used for assessment of pain detection (cPDTs) and pain tolerance (cPTTs) thresholds, TSP, and CPM. Offset analgesia (OA) was assessed using heat stimulation. Propranolol significantly reduced heart rate (p<0.001), blood pressure (p<0.02) and increased HRV (p<0.01) compared with placebo. No significant differences were found comparing cPDT (p>0.70), cPTT (p>0.93), TSP (p>0.70), OA-effect (p>0.87) or CPM (p>0.65) between propranolol and placebo. The current study demonstrated that propranolol increased HRV, but did not affect pressure pain sensitivity or any pain facilitatory or modulatory outcomes. Analgesic effects of propranolol have been reported in clinical pain populations and the results from the current study could indicate that increased HRV from propranolol is not associated with peripheral and central pain pathways in healthy male subjects.

Keywordsβ-blockers; heart rate variability; conditioned pain modulation; offset analgesia; temporal summation of pain; pressure pain threshold
Year2018
JournalScandinavian Journal of Pain
Journal citation18 (3), pp. 479-489
PublisherElsevier Ltd
ISSN1877-8860
Digital Object Identifier (DOI)https://doi.org/10.1515/sjpain-2018-0054
Scopus EID2-s2.0-85048389959
Publication process dates
Deposited13 May 2021
Permalink -

https://acuresearchbank.acu.edu.au/item/8w0qz/the-effects-of-propranolol-on-heart-rate-variability-and-quantitative-mechanistic-pain-profiling-a-randomized-placebo-controlled-crossover-study

  • 96
    total views
  • 0
    total downloads
  • 2
    views this month
  • 0
    downloads this month
These values are for the period from 19th October 2020, when this repository was created.

Export as

Related outputs

Intranasal oxytocin reduces heart rate variability during a mental arithmetic task: A randomised, double-blind, placebo-controlled cross-over study
Tracy, Lincoln M., Gibson, Stephen J., Labuschagne, Izelle, Georgiou-Karistianis, Nellie and Giummarra, Melita J.. (2018). Intranasal oxytocin reduces heart rate variability during a mental arithmetic task: A randomised, double-blind, placebo-controlled cross-over study. Progress in Neuropsychopharmacology and Biological Psychiatry. 81, pp. 408 - 415. https://doi.org/10.1016/j.pnpbp.2017.08.016
Sex-specific effects of intranasal oxytocin on thermal pain perception: A randomised, double-blind, placebo-controlled cross-over study
Tracy, Lincoln M., Labuschagne, Izelle, Georgiou-Karistianis, Nellie, Gibson, Stephen J. and Giummarra, Melita J.. (2017). Sex-specific effects of intranasal oxytocin on thermal pain perception: A randomised, double-blind, placebo-controlled cross-over study. Psychoneuroendocrinology. 83, pp. 101 - 110. https://doi.org/10.1016/j.psyneuen.2017.05.028
Sex differences in empathy for pain: What is the role of autonomic regulation?
Tracy, Lincoln M. and Giummarra, Melita J.. (2017). Sex differences in empathy for pain: What is the role of autonomic regulation? Psychophysiology. 54(10), pp. 1549 - 1558. https://doi.org/10.1111/psyp.12895
Effects of explicit cueing and ambiguity on the anticipation and experience of a painful thermal stimulus
Tracy, Lincoln M., Gibson, Stephen J., Georgiou-Karistianis, Nellie and Giummarra, Melita J.. (2017). Effects of explicit cueing and ambiguity on the anticipation and experience of a painful thermal stimulus. PLoS ONE. 12(8), pp. 1 - 24. https://doi.org/10.1371/journal.pone.0183650
Location, location, location: Variation in sensitivity to pain across the body
Tracy, Lincoln M., Georgiou-Karistianis, Nellie, Gibson, Stephen J. and Giummarra, Melita J.. (2016). Location, location, location: Variation in sensitivity to pain across the body. European Journal of Pain. 20(10), pp. 1721 - 1729. https://doi.org/10.1002/ejp.895
Meta-analytic evidence for decreased heart rate variability in chronic pain implicating parasympathetic nervous system dysregulation
Tracy, Lincoln M., Ioannou, Liane, Baker, Katharine S., Gibson, Stephen J., Georgiou-Karistianis, Nellie and Giummarra, Melita J.. (2016). Meta-analytic evidence for decreased heart rate variability in chronic pain implicating parasympathetic nervous system dysregulation. Pain. 157(1), pp. 7 - 29. https://doi.org/10.1097/j.pain.0000000000000360
A randomised controlled trial of caseload midwifery care: M@NGO (Midwives @ New Group practice Options)
Tracy, S., Hartz, D., Hall, B., Allen, Jyai D., Forti, A., Lainchbury, A., White, J., Walsh, A., Tracy, M. and Kildea, Sue. (2011). A randomised controlled trial of caseload midwifery care: M@NGO (Midwives @ New Group practice Options). BMC Pregnancy and Childbirth. 11(82), pp. 1 - 8. https://doi.org/10.1186/1471-2393-11-82