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Changes in electrical conductivity of the skin due to painful stimuli in newborns of different gestational categories and comparison with changes in selected physiological parameters


Authors: J. Macko 1;  P. Humpolíček 2;  D. Moravčíková 3;  L. Kantor 4;  M. Kotíková 1
Authors‘ workplace: Novorozenecké oddělení, Krajská nemocnice Tomáše Bati, Zlín primář MUDr. J. Macko 1;  Institut zdravotnických studií, Univerzita Tomáše Bati, Zlín vedoucí Mgr. M. Cichá, Ph. D. 2;  Ústav porodní asistence, Institut zdravotnických studií, Univerzita Tomáše Bati, Zlín vedoucí Mgr. L. Reslerová, Ph. D. 3;  Novorozenecké oddělení, Fakultní nemocnice, Olomouc primář MUDr. L. Kantor 4
Published in: Čes-slov Pediat 2011; 66 (6): 363-371.
Category: Original Papers

Overview

Pain in neonates is globally regarded as a highly undesirable phenomenon. Many studies have been confirmed that the pain feels as mature newborns and premature babies born. So far, however, there is no objective method of assessing pain in these patients who cannot yet verbalize their pain. One of the objectives of this study was to explore the use of measuring changes in electrical skin conductance as an objective criterion for evaluating the perception of pain in neonates. Given the experience of pain affects the physiological functions of the organism, the next objective was to ascertain the relationship between changes in skin conductance and changes in selected physiological parameters.

Patients:
The study included a total of 57 babies born in KNTB in Zlín in the first half of 2010. Infants were divided according to gestational age in the following 3 groups: group A: 41+6–36+0 (19 neonates), group B: 35+6–32+0 (25 neonates), group C: 31+6–25+0 (13 newborns).

Results:
As the most sensitive parameter for changes in skin conductance rating of pain seems to be the peak per second (PPS), other parameters of skin conductance and selected physiological parameters measured do not correlate with each other. The results could not determine basal skin conductance levels. A comparison of gestational age and parameters of skin conductance weren´t also demonstrate significant correlation. Gestational age also doesn´t affect the electrical parameters of skin conductance changes.

Conclusion:
We can conclude that the evaluation of pain in both mature and premature newborns requires individual assessment. Changes in skin conductance are probably influenced by other factors, not just the emergence of painful stimulus. The present study suggests, that pain assessment in neonates only measured by changes in electrical skin conductivity cannot replace the full range of established practices and vice versa is necessary to take into account the complexity of the perception of pain using a combination of several methods.  

Key words:
electrical conductivity of the skin, infants, Prechtl, saturation, heart rate, gestational age


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Neonatology Paediatrics General practitioner for children and adolescents
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