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Updated: Jun 30, 2026

Objective Nociceptive Assessment in Ventilated ICU Patients: A Feasibility Study Using Pupillometry and the Nociceptive Flexion Reflex
Published on: July 4, 2018
Reliability of the nociceptive flexor reflex (RIII) threshold and association with Pain threshold
Peter S Micalos1, Eric J Drinkwater, Jack Cannon
1School of Human Movement Studies, Charles Sturt University, Bathurst, NSW, Australia. pmicalos@csu.edu.au
Abstract:
The purpose of this study was to assess the reliability of the RIII reflex threshold and Pain threshold in three repeated trials using electrocutaneous stimuli. Each trial was separated by a mean of 4.3 +/- 2.9 days (between-trials) and included two repeated measurements (within-trial) of the RIII reflex threshold (RIII-T) and the Pain threshold (PT) separated by 20 min. The participants were 14 healthy males (mean age +/- SD, 23.5 +/- 5.3 years). There was a significant difference between the RIII-T and PT. The reliability of the RIII-T and PT shows a between-trials coefficient of variance (CV(SEM)) of 16.1 and 16.9%, respectively. The within-trial CV(SEM) for RIII-T and PT was 5.4 and 4.3%, respectively. There was a significant correlation between the RIII-T threshold and PT. The parallel association and correlation of the RIII-T with the PT suggests that the RIII-T is valid in experimental pain studies under standardised resting conditions.
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