Monitoring of skin conductance to assess postoperative pain intensity

Ledowski, Thomas; Bromilow, J.; Paech, Michael J.; Storm, Hanne; Hacking, Reena; Schug, Stephan A.

doi:10.1093/bja/ael280

Cited by 91 publications

(107 citation statements)

References 13 publications

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Section: Discussionsupporting

confidence: 63%

“…The resulting change of sweat gland filling can be measured in terms of skin conductance. The number of fluctuations within the mean skin conductance per second has been reported to correlate well with intra-operative noxious stimuli, with a sensitivity and specificity of 86% for their detection [6].In a pilot study [7] we confirmed correlation between the number of fluctuations of skin conductance per second and postoperative pain in the recovery room rated on a numeric rating scale (0-10). As the number of fluctuations of skin conductance per second was highly Anaesthesia, 2007, 62, pages 989-993 …”

supporting

confidence: 72%

“…In a pilot study [7] we confirmed correlation between the number of fluctuations of skin conductance per second and postoperative pain in the recovery room rated on a numeric rating scale (0-10). As the number of fluctuations of skin conductance per second was highly variable between subjects, a cut-off value of 0.1 was calculated post hoc as achieving the highest sensitivity (89%) and specificity (74%) for distinguishing between patients with no or mild, or moderate and severe pain.…”

supporting

confidence: 63%

“…Given that statistically significant data had been obtained in the pilot study [7], a total of 100 skin conductance readings might have been sufficient to evaluate the derived cut-off values prospectively. However, because our aim was to test the cut-off value in a larger population, we opted to obtain at least 150 readings per group for patients with either no or mild pain, or moderate or severe pain.…”

Section: Methodsmentioning

confidence: 99%

“…Prospectively tested, the number of fluctuations of skin conductance per second cut-off value of 0.1 (as obtained from the pilot study [7]) gave a 88.5% sensitivity and a 67.7% specificity for differentiating between patients with no or mild pain, and those with moderate or severe pain. Receiver operating characteristic curve analysis revealed a greater area under the curve for the number of fluctuations of skin conductance per second (75.5%) compared to systolic blood pressure (53.2%) and heart rate (50.5%; Fig.…”

Section: Methodsmentioning

confidence: 99%

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The assessment of postoperative pain by monitoring skin conductance: results of a prospective study*

Ledowski¹,

Bromilow

et al. 2007

Anaesthesia

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109

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SummaryThe number of fluctuations of skin conductance per second correlates with postoperative pain. The aim of this prospective study was to test the cut-off value for the number of fluctuations of skin conductance per second obtained from a previous study. Seventy-five patients were asked to quantify their level of pain on a numeric rating scale (0-10) in the recovery room. The number of fluctuations of skin conductance per second was recorded simultaneously. The number of fluctuations of skin conductance per second was different between patients with no (0.07), mild (0.16), moderate (0.28) and severe pain (0.33); p < 0.001. The tested cut-off value for the number of fluctuations of skin conductance per second (0.1) distinguished a numeric rating scale £ 3 from > 3 with 88.5% sensitivity and 67.7% specificity. The number of fluctuations of skin conductance per second may be a useful means of assessing postoperative pain. Postoperative complications may be prevented by a suitable choice of analgesic technique [1]. Moreover, adequate pain control is a prerequisite for the use of rehabilitation programmes to accelerate recovery from surgery [1], and existing data indicate that effective pain relief may lead to an improved overall postoperative outcome [2].Accurate assessment of postoperative pain is a key factor for successful pain management. Though various scoring systems are available for this purpose, they rely almost entirely on the co-operation of the patient. Hence these systems are bound to fail in unconscious, confused or otherwise uncooperative subjects. A more objective, subject-independent parameter for the assessment of pain is therefore highly desirable. As pain greatly modifies the surgical stress response [3], monitoring of parameters of postoperative stress, such as sympathetic tone, could be a helpful tool for assessment of analgesia. Increased sympathetic tone leads to a higher rate of firing in sympathetic, postganglionic cholinergic neurones [4,5]. The resulting change of sweat gland filling can be measured in terms of skin conductance. The number of fluctuations within the mean skin conductance per second has been reported to correlate well with intra-operative noxious stimuli, with a sensitivity and specificity of 86% for their detection [6].In a pilot study [7] we confirmed correlation between the number of fluctuations of skin conductance per second and postoperative pain in the recovery room rated on a numeric rating scale (0-10). As the number of fluctuations of skin conductance per second was highly Anaesthesia, 2007, 62, pages 989-993

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Section: Discussionsupporting

confidence: 63%

supporting

confidence: 72%

supporting

confidence: 63%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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