Pediatrics & Therapeutics
Open Access

Abstract

The Capability of Skin Conductance to Monitor Pain Compared to Other Physiological Pain Assessment Tools in Children and Neonates

Hanne Storm

Background: In some European countries and the US it is mandatory to assess and treat pain.  In Pubmed there are more than 240 papers when searching for “skin conductance” and “pain”.
Aims: The aim is to review the utility of the skin conductance responses (SCR)/sec to assess pain in infants and children.
Study design: Two searches in Pubmed, where one includes the key words “skin conductance”, “pain”, and “children”. Search two included “skin conductance”, “pain”, and “infants”.  The finds in these searches are discussed and compared with other physiological pain assessment tools.
Outcome measures: Search one; regarding children, included twelve papers, and search two, regarding infants, included 20 papers.
Results: All the found papers show that the SCR/sec increases during defined painful procedures. Postoperatively, at intensive care units, and at neonatal units, the SCR/sec shows high sensitivity to monitor pain, but a lower specificity. The the SCR/sec is the most accurate means to assess pain when compared to the HR and peripheral oxygen saturation.
HR is influenced from respiratory rhythm, changes in blood volume status, drugs acting on the blood circulation, environmental temperature, and emotional stress, and is therefore less specific to pain than the SCR/sec which only is influenced from emotional stress. For infants and children, variation for SCR/sec is low compared to HR and peripheral oxygen saturation when the patients are at the same pain/discomfort level.
Conclusions: The SCR/sec could be adjunctive warning tool for when to validate possible pain.