Skin conductance as a marker of pain in infants of different gestational age

Abstract

Aims. To assess the use of skin conductance as an objective measure of pain in infants of different gestational age. A second aim was to investigate the relationship between skin conductivity and selected physiological and behavioural variables (oxygen saturation, heart rate and behavioural state). Methods. Infants were divided according to gestational age into the following 3 groups; group A: 25+0 -31+6 weeks (13 infants), group B: 32+0 -35+6 weeks (25 infants), group C: 36+0 -41+6 weeks (19 infants). The pain stimulus was blood sampling. Results. The most sensitive parameter for describing changes in skin conductance related to pain was peak per second. No other parameter correlated with the physiological variables chosen. The results showed that the inability to determine basal skin conductance is a crucial disadvantage to practical application. The lack of correlation between conductance parameters and gestational age is surprising. Conclusion. We conclude that the Peak per Second is the best parameter for evaluating skin conductance in infants and it is not influenced by gestational age. Peaks per Second correlate only with Prechtl's Scale of behavioural state and not with the physiological parameters chosen.

Heightened sympathetic arousal is demonstrated by skin conductance responsivity to auditory stimuli in a small cohort of neonates with opiate withdrawal

“…Another recent study corroborates with our findings; showing that the SC of newborns treated for NAS were significantly higher compared with unexposed controls (Schubach et al, 2016). Consistent with our findings, other studies that have examined infant's SC responses to stimuli such as heel lance and noise report increased EDRs/sec and mean of peaks (Macko et al, 2013;Salavitabar et al, 2010;Harrison et al, 2006). These studies, however, were not done in opiate dependent infants.…”

“…Such arousal can be induced by various stimuli such as pain, noise, tactile stimulation, etc., under both naturalistic and experimental situations. Skin conductance has been utilized in clinical studies as a method for assessing pain and arousal in neonates and infants (Hellerud and Storm, 2002;Macko et al, 2013). The lack of objective methods of assessment in NAS is an ongoing problem that must be solved because the subjective nature of available screening tools, to date, has contributed to improper diagnosis, increased length of hospital stay, infant and maternal distress, and additional challenges to families and health care systems.…”

Multimodal Pain Management in Extremely Low Birth Weight Neonates after Major Abdominal Surgery

“…Surprisingly, it seems that conductance parameters do not correlate with gestational age, and their changes have been described in neonates as early as 22 gestational weeks. The major limitation of the method is the inability to determine basal skin conductance in this population [26].…”