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Skin conductance measurements as pain assessment in newborn infants born at 22-27weeks gestational age at different postnatal age.
MedLine Citation:
PMID:  21764228     Owner:  NLM     Status:  Publisher    
BACKGROUND: To assess pain or stress in newborn infants submitted to intensive care is important but difficult, as different observational pain scales are not always reliable in premature infants. As an indicator of pain, skin conductance (SC) measurements have detected increased sweating in newborn infants >28 gestational age (GA) submitted to heel lancing. OBJECTIVE: To measure SC during heel lancing and routine care in newborn infants, born at 22 to 27 GA, with special relation to postnatal age (PNA). METHODS: In six infants <28+0 GA and 4 infants ≥28+0 GA spontaneous SC activity and behavioural state (Neonatal Pain Agitation and Sedation Scale (N-PASS)) was measured before, during and after each intervention. Measurements were repeated in each patient at different PNA. RESULTS: Baseline SC prior to intervention took longer time to stabilise and was higher in <28 than in ≥28+0 PNA. The combination of heel lancing and squeezing gave an increased SC in <28 PNA, whereas heel lancing alone gave the same SC response in ≥28+0 PNA. A possibly continued immature response in SC measurements was not observed. Oral glucose admission prior to heel lancing increased SC. Routine care did not give any changes in SC. Except during orogastric tube placement no signs of discomfort or pain could be detected by the neonatal pain, agitation and sedation scale (N-PASS) in <28 PNA. CONCLUSION: Changes in SC could be detected in infants at <28+0 PNA and related to the combination of heel lancing and squeezing. A maturational development of the SC was observed in infants born <28 GA. SC seems to be able to differentiate between pain and discomfort.
Josanne Munsters; Linda Wallström; Johan Agren; Torgny Norsted; Richard Sindelar
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-7-15
Journal Detail:
Title:  Early human development     Volume:  -     ISSN:  1872-6232     ISO Abbreviation:  -     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-7-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7708381     Medline TA:  Early Hum Dev     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier Ltd. All rights reserved.
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; Radboud University Nijmegen, Department of Paediatrics, Medical Centre Nijmegen, The Netherlands.
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