Skin conductance peaks could result from changes in vital parameters unrelated to pain

Valkenburg, Abraham J.; Niehof, Sjoerd P.; Dijk, Monique van; Verhaar, Esther J.M.; Tibboel, Dick

doi:10.1038/pr.2011.72

Cited by 36 publications

(30 citation statements)

References 25 publications

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“…112,113 Some studies reported that SC lacks specificity for discriminating between the painful and nonpainful procedures, 108,112 and SC increased when the infant was given glucose as an analgesic before heel lancing. 113 Skin conductance was also found to be correlated with infant body temperature 109 and is sensitive for body movement artifacts. 114 The wide range of sensitivity and specificity for SC has not made it readily acceptable for clinical practice, 93 especially in preterm infant, and as such it needs further investigation.…”

Section: Skin Conductancementioning

confidence: 97%

Pain Assessment and Measurement in Neonates

Cong

McGrath

Cusson

et al. 2013

Advances in Neonatal Care

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Pain assessment and measurement are the cornerstones of pain management. Pain assessment connotes a comprehensive multidimensional description. Conversely, pain measurement provides a numeric quantitative description of each factor illustrating pain qualities. Pain scales provide a composite score used to guide practice and research. The type of infant pain instrument chosen is a significant factor in guiding pain management practice. The purpose of this review was to summarize current infant pain measures by introducing a conceptual framework for pain measurement. Although more than 40 infant pain instruments exist, many were devised solely for research purposes; several of the newly developed instruments largely overlap with existing instruments. Integration of pain management into daily practice remains problematic. Understanding how each instrument measures infant pain allows clinicians to make better decisions about what instrument to use with which infant and in what circumstances. In addition, novel new measurement techniques need further testing.

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Section: Skin Conductancementioning

confidence: 97%

Pain Assessment and Measurement in Neonates

Cong

McGrath

Cusson

et al. 2013

Advances in Neonatal Care

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“…Because SCF are induced by acetylcholine acting on muscarinic receptors, they are not affected by environmental temperature, hemodynamic changes or respiratory rhythm medications such as beta blockers and neuromuscular blockers (Bini et al, 1980; Macefield & Wallin, 1996; Wallin, 1978). Furthermore, changes in respiratory rhythm (including apnea) do not influence SCF (Habler et al, 1993; Hanada, Sander & Gonzalez-Alonso, 2003; Valkenburg et al, 2012). Thus, changes in skin conductance are considered useful to monitor nociceptive stimulation and pain (Storm, 2008).…”

Section: Introductionmentioning

confidence: 97%

Pain assessment in children undergoing venipuncture: the Wong–Baker faces scale versus skin conductance fluctuations

Savino

Vagliano

Ceratto

et al. 2013

PeerJ

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The aim of this study was to evaluate the efficacy of the subjective Wong–Baker faces pain rating scale (WBFS) and of the objective skin conductance fluctuation (SCF) test in assessing pain in children undergoing venipuncture. One-hundred and fifty children (aged 5–16 years) entered the study. All underwent venipuncture at the antecubital fossa to collect blood specimens for routine testing in the same environmental conditions. After venipuncture, the children indicated their pain intensity using the WBFS, whereas the number of SCFs was recorded before, during and after venipuncture. So, pain level was measured in each child with WBFS and SCF. We found that the level of WBFS-assessed pain was lower in all children, particularly those above 8 years of age, than SCF-assessed pain (p < 0.0001). Moreover, the number of SCFs was significantly higher during venipuncture than before or after venipuncture (p < 0.0001). At multivariate regression analysis, age and previous experience of venipuncture influenced the WBFS (β = −1.81, p < 0.001, and β = −0.86, p < 0.001, respectively) but not SCFs. In conclusion, although both procedures can be useful for research and clinical practice, our findings show that WBFS was affected by age and previous venipuncture, whereas SCF produced uniform data. If verified in other studies, our results should be taken into account when using these tools to evaluate pain in children.

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“…53 However, in an effort to validate the technique in another unit, researchers documented that skin conductance correlated highly with skin temperature, and significant changes in all other vital parameters were observed comparing before- and after-peak data. 54 These results indicate that sympathetic neural activity to maintain homeostasis (such as autoregulation of the skin temperature) also result in skin conductance peaks. Consequently, such ‘objective’ techniques should be further improved and validated before introduction into daily clinical neonatal practice for the evaluation of pain.…”

Section: Clinical Practice and Research Directions: In Search Of Amentioning

confidence: 95%

“…Consequently, such ‘objective’ techniques should be further improved and validated before introduction into daily clinical neonatal practice for the evaluation of pain. 51–54 …”

Section: Clinical Practice and Research Directions: In Search Of Amentioning

confidence: 99%

Pharmacological treatment of neonatal pain: In search of a new equipoise

Allegaert

Tibboel

Anker

2013

Seminars in Fetal and Neonatal Medicine

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SUMMARY Inadequate management of pain in early human life contributes to impaired neurodevelopmental outcome and alters pain thresholds, pain or stress-related behavior and physiological responses. However, there are also emerging animal experimental data on the impact of exposure to analgo-sedatives on the incidence and extent of neuro-apoptosis. Since this association has also been suggested in humans, the pharmacological treatment of neonatal pain is in search of a new equipoise since these ‘conflicting’ observations are the main drivers to further reconsider our current treatment regimens. This review focuses on new data concerning clinical pharmacology of morphine, followed by data on more recently introduced opioids like remifentanil and tramadol, locoregional anesthesia and minimally invasive techniques in neonates, and finally with data on intravenous paracetamol. Since the available data are still incomplete, priorities for both clinical management and future research will be proposed.

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Skin conductance peaks could result from changes in vital parameters unrelated to pain

Cited by 36 publications

References 25 publications

Pain Assessment and Measurement in Neonates

Pain Assessment and Measurement in Neonates

Pain assessment in children undergoing venipuncture: the Wong–Baker faces scale versus skin conductance fluctuations

Pharmacological treatment of neonatal pain: In search of a new equipoise

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