Guidelines for the cold pressor task as an experimental pain stimulus for use with children

Abstract

The cold pressor task (CPT) involves placing a hand or forearm in cold water, a stimulus that produces a slowly mounting pain of mild to moderate intensity and is terminated by voluntary withdrawal of the limb. The CPT has been used in many studies of pain, autonomic reactivity, and hormonal stress responses. Use of the CPT with children was first reported in 1937, and it has been used since then in at least 24 published studies including more than 1700 children without reported adverse effects. However, differences in water temperature, apparatus, and procedure might contribute to conflicting results. We offer suggested guidelines for the safe construction and operation of apparatus for the CPT and for consistent administration of the task and measurement. In particular, use of continuously circulating water at a temperature of 10 degrees C +/- 1 degrees C is recommended for the CPT with children and adolescents. Data on children's pain tolerance found in CPT studies in the authors' laboratories are provided.

Perspective: Differences in methodology might have contributed to conflicting results in published research using the CPT with children. These guidelines for apparatus and for administration of the CPT might be helpful to researchers planning such studies. Questions for research leading toward further methodologic refinement are identified.