Measurement of skin conductance responses to evaluate procedural pain in the perioperative setting

Background and aims: The subjective nature of pain makes objective, quantitative measurements challenging. The current gold standard for evaluating pain is patient self-reporting using the numeric rating scale (NRS) or Visual Analog Scale. Skin conductance responses per second (SCR) measured in the palmar region reflect the emotional part of the autonomous nervous system. SCR ≥0.20 have been shown to indicate moderate or severe pain in the postoperative setting. We examined whether SCR can detect procedure-related pain before major surgery. Methods: In 20 patients being prepared for major surgery SCR was recorded before and during arterial cannulation, after induction of anaesthesia, and on the first postoperative day. Self-reported pain was evaluated using NRS. NRS >3 was considered to represent moderate or severe pain. Results: NRS was 0 [0–0] before arterial cannulation, increasing to 5 [3–6] during arterial cannulation (p<0.05). Before arterial cannulation SCR was 0.27 [0.20–0.27], increasing to 0.33 [0.30–0.37] during arterial cannulation (p<0.01). On the first postoperative day both SCR and reported pain indicated no more than mild pain, SCR 0.13 [0.00–0.20] and NRS 2.0 [0.5–2.0]. The sensitivity of SCR to indicate moderate or severe pain (NRS >3) was 0.93 (0.68–1.0) and specificity was 0.33 (0.25–0.35) when the cut-off established in the postoperative setting (SCR ≥0.20) was used on all data. Conclusions: SCR increased during arterial cannulation. Before major surgery the SCR was above the threshold demonstrated to indicate pain in the postoperative setting, even without painful stimuli and no reported pain. Using the threshold established for postoperative pain, SCR cannot reliably discriminate between pain and other stressors before major surgery. Implications: Before major surgery, the diagnosis of moderate or severe pain should not be made based on SCR ≥0.20.

Standort
Deutsche Nationalbibliothek Frankfurt am Main
Umfang
Online-Ressource
Sprache
Englisch

Erschienen in
Measurement of skin conductance responses to evaluate procedural pain in the perioperative setting ; volume:18 ; number:4 ; year:2018 ; pages:639-644 ; extent:6
Scandinavian journal of pain ; 18, Heft 4 (2018), 639-644 (gesamt 6)

Urheber
Svalebjørg, Morten
Storm, Hanne
Olsen, Roy Bjørkholt
Bugge, Jan Frederik

DOI
10.1515/sjpain-2018-0088
URN
urn:nbn:de:101:1-2024022714485031485565
Rechteinformation
Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
Letzte Aktualisierung
14.08.2025, 10:54 MESZ

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Beteiligte

  • Svalebjørg, Morten
  • Storm, Hanne
  • Olsen, Roy Bjørkholt
  • Bugge, Jan Frederik

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