Pain rather than induced emotions and ICU sound increases skin conductance variability in healthy volunteers

Günther, Anders; Schandl, Anna; Berhardsson, J.; Bjärtå, Anna; Wallgren, Max; Sundin, Örjan; Alvarsson, Jesper; Bottai, Matteo; Martling, CR; Sackey, Peter

doi:10.1111/aas.12751

Cited by 11 publications

(18 citation statements)

References 26 publications

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“…The efferent skin sympathetic nervous system, emotional sweating, mirrored by number of skin conductance responses per sec (NSCR) or skin conductance response amplitude, have been found to mirror sudomotor activity in anesthetized and conscious animals and humans . NSCR has been used to assess pain in patients, post‐operatively and in Intensive Care Unit (ICU) patients, as well as during nociceptive stimuli in patients undergoing anesthesia …”

Section: Introductioncontrasting

confidence: 91%

Measuring pain—Physiological and self‐rated measurements in relation to pain stimulation and anxiety

Storm

Günther

Sackey

et al. 2019

Acta Anaesthesiol Scand

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Introduction:The aim of the present study was to investigate how emotions influence pain, measured by one subjective self-rated measure, the numeric rating scale (NRS), and one objective physiological measure, the number of skin conductance responses (NSCR). Method:Eighteen volunteers were exposed to conditions with pictorial emotional stimuli (neutral, positive, negative), authentic ICU-sound (noise, no-noise) and electrical stimulation (pain, no-pain) individually titrated to induce moderate pain. When using all combinations of picture inducing emotions, sound, and pain, each of these conditions (12 conditions lasting for 60 seconds each) were followed by pain ratings.Ratings of arousal (low to high) and valence (pleasant to unpleasant) were used as indicators of affective state for each condition. Mean NSCR was also measured throughout the experiment for each condition.Results: Even though NRS and NSCR increased during painful stimuli, they did not correlate during the trial. However, NSCR was positively correlated with the strength of the electrical stimulation, r = 0.48, P = 0.046, whereas NRS showed positive correlations with the anxiety level, assessed by affective ratings (arousal, r = 0.61, P < 0.001, and valence, r = 0.37, P < 0.001). Conclusions:The NRS was strongly influenced by affective state, with higher pain ratings during more anxiety-like states, whereas NSCR correlated to the strength of electrical pain stimulation. That reported pain is moderated by anxiety, puts forward a discussion whether reduction of the anxiety level should be considered during analgesia treatment.| 669 STORM eT al.

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Section: Introductioncontrasting

confidence: 91%

Measuring pain—Physiological and self‐rated measurements in relation to pain stimulation and anxiety

Storm

Günther

Sackey

et al. 2019

Acta Anaesthesiol Scand

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“…propofol or dexmedetomidine) is a prospective that needs to be assessed too. The reports from pediatric patients may suggest EDA monitor as an analgesia monitor; but even them are few (23)(24)(25)(26). The aforementioned reveal a huge range of challenges that remain to be met for ICU patients.…”

Section: Discussionmentioning

confidence: 99%

“…Unfortunately, till the conduct of the present study, there were only few reports about EDA measurements in adult (7)(8)(9) or peadiatric (10-11) ICU environment. In adult patients, results were not conclusive.…”

Section: Introductionmentioning

confidence: 86%

Electrodermal Activity Monitoring During Painful Stimulation in Sedated Adult Intensive Care Unit Patients: a Pilot Study

Aslanidis

Grosomanidis

Karakoulas

et al. 2018

Acta Med. (Hradec Kralove, Czech Repub.)

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“…Cut off for NSCF counting was >0.005, much more sensitive than the >0.02 μS used in relative pain monitoring literature. 20 Signal quality <80% was considered artifact and the measurement was also excluded.…”

Section: Methodsmentioning

confidence: 99%

“…17,18 Yet, the vast majority of literature is coming for operation room setting or post anaesthesia unit care and perioperative EDA measurements have been used mainly as analgesia index. 17 Only recently, there are reports about EDA measurements in adult [19][20] or peadiatric ICU environment 17,21 . Thus, the overall data are scarce.…”

mentioning

confidence: 99%

Electrodermal Activity Monitoring during Endotracheal Suction in Sedated Adult Intensive Care Unit Patients

et al. 2018

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Background: Endotracheal suctioning of respiratory secretions is one of the most common causes of pain and discomfort in Intensive Care Unit environment. The electrical properties of the skin, also known as electrodermal activity (EDA), are considered as an indirect measure of autonomous nervous system. Aim: This study explores EDA changes during endotracheal suction in sedated adult critical care patients; and compares these changes to other monitoring parameters. Materials and methods: Skin conductance variability, selected hemodynamic and respiratory parameters, bispectral index (BIS) and ambient noise level, were monitored during 4 hour routine daytime intensive care nursing and treatment in an adult Intensive Care Unit. 4h-measurements were divided into 2 groups, based upon the sedation level (group A: Ramsay sedation scale 2-4 and group B: 5-6 respectively) of the patients. Selected recordings before and after endotracheal suction (stress events) were performed. Seven stress events from Group A and 17 from Group B were included for further analysis. Patients’ demographics, laboratory exams and severity scores were recorded. Pain status evaluation before every event was also performed via 2 independent observers. Results: In both groups the rate of EDA changes was greater than in other monitoring parameters. Yet, in group A only selected parameters were significantly changed after the start of the procedure, while in group B, every parameter showed significant change (p<0.05). Groups were similar for other co-founding factors. Conclusion: EDA measurements are more sensitive to stress stimuli, than cardiovascular, respiratory or even BIS monitoring. Deeper sedation seems to affect more the intensity of EDA changes during suction.

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Pain rather than induced emotions and ICU sound increases skin conductance variability in healthy volunteers

Abstract: In healthy volunteers, NSCF appears to reflect ongoing autonomous reactions mainly to pain and to a lesser extent, reactions to emotion induced with IAPS pictures or ICU sound.

Cited by 11 publications

References 26 publications

Measuring pain—Physiological and self‐rated measurements in relation to pain stimulation and anxiety

Measuring pain—Physiological and self‐rated measurements in relation to pain stimulation and anxiety

Electrodermal Activity Monitoring During Painful Stimulation in Sedated Adult Intensive Care Unit Patients: a Pilot Study

Electrodermal Activity Monitoring during Endotracheal Suction in Sedated Adult Intensive Care Unit Patients

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