Assessment of pain in critically ill children. Is cutaneous conductance a reliable tool?

Journal of Critical Care
M J SolanaJ M Bellon

Abstract

The purpose of this study is to assess the usefulness and accuracy of skin conductance (SC) as a tool to evaluate the level of sedation and pain in pediatric critical patients during painful procedures and to compare it with hemodynamic variables, clinical scales, and bispectral index (BIS). This is a prospective observational study in 61 critical children undergoing invasive procedures. Hemodynamic data (heart rate and arterial blood pressure), clinical scales punctuation (Ramsay, COMFORT, and numeric rating pain scales), BIS, and the number of fluctuations of SC per second were collected before, during, and at the end of the procedure. The mean age of the patients was 42.9 (range, 1 month to 16 years). Seventy-two point six percent were postcardiac surgery patients. Nonmuscle-relaxed patients showed a moderate increase in heart rate (P = .02), numeric rating pain scales (P = .03), and Ramsay scale (P = .002). The number of fluctuations of SC per second increased significantly during the procedure (basal, 0.1; maneuver, 0.2; P = .015), but it never reached the level considered as pain or stress nor did it precede clinical scales or BIS. None of the variables studied showed a significant change during the procedure in muscle-re...Continue Reading

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Citations

Oct 28, 2016·Expert Review of Clinical Pharmacology·Manuel A BaarslagDick Tibboel
Oct 21, 2019·Acta Paediatrica·Alejandro Avila-AlvarezMontserrat Cabana Vazquez
Jul 11, 2019·JBI Database of Systematic Reviews and Implementation Reports·Mauro MotaEduardo Santos
Dec 30, 2016·The Clinical Journal of Pain·Kyle J Morgan, Doralina L Anghelescu
Jun 28, 2018·Journal of Clinical Monitoring and Computing·Mingzhe JiangPasi Liljeberg
Feb 3, 2020·Veterinary Anaesthesia and Analgesia·Patricia Ruíz-LópezMaría Del Mar Granados
Mar 13, 2021·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Maximilian D MauritzPhilipp Deindl
Oct 3, 2021·NeoReviews·Wojciech WalasAndrzej Piotrowski

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