Normalized skin conductance level could differentiate physical pain stimuli from other sympathetic stimuli.
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
02 07 2020
02 07 2020
Historique:
received:
26
07
2019
accepted:
17
06
2020
entrez:
4
7
2020
pubmed:
4
7
2020
medline:
2
12
2020
Statut:
epublish
Résumé
Skin conductance monitoring is one of the promising methods for objectively evaluating pain. However, skin conductance might possibly increase in response to sympathetic stimulation other than pain. In this study, we aimed to test whether skin conductance monitoring can distinguish physical pain stimulation (heat, mechanical and cold stimulation) from other sympathetic stimuli (stimulation by noise and painful images). Twenty-three healthy volunteers participated in this prospective observational study. The number of fluctuations in skin conductance (NFSC) and normalized skin conductance level (nSCL) were measured and compared with pain scores on a self-reported pain scale (numerical pain scale [NPS]). Both NFSC and nSCL increased during mechanical stimulation. Further, nSCL, but not NFSC, well reflected heat stimulus intensity, suggesting its ability to quantitatively evaluate pain. nSCLs during physical pain stimulation were greater than those during other sympathetic stimulations. However, NFSC was not able to completely distinguish between the stimuli. These results suggest that nSCL could better differentiate physical pain stimuli from other sympathetic stimuli than NFSC. In comparisons between subjective and objective pain assessment in the same individual, nSCL correlated better with NPS score, indicating the possibility of being able to monitor the transition of pain. Monitoring changes in skin conductance using nSCL might be useful for objectively detecting physical pain.
Identifiants
pubmed: 32616939
doi: 10.1038/s41598-020-67936-0
pii: 10.1038/s41598-020-67936-0
pmc: PMC7331661
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
10950Références
Joyce, C. R., Zutshi, D. W., Hrubes, V. & Mason, R. M. Comparison of fixed interval and visual analogue scales for rating chronic pain. Eur. J. Clin. Pharmacol. 8, 415–420. https://doi.org/10.1007/bf00562315 (1975).
doi: 10.1007/bf00562315
pubmed: 1233242
Garcia-Larrea, L. & Peyron, R. Pain matrices and neuropathic pain matrices: a review. Pain 154(Suppl 1), S29–S43. https://doi.org/10.1016/j.pain.2013.09.001 (2013).
doi: 10.1016/j.pain.2013.09.001
pubmed: 24021862
Bonica, J. J. The need of a taxonomy. Pain 6, 247–248 (1979).
doi: 10.1016/0304-3959(79)90046-0
Cowen, R., Stasiowska, M. K., Laycock, H. & Bantel, C. Assessing pain objectively: the use of physiological markers. Anaesthesia 70, 828–847. https://doi.org/10.1111/anae.13018 (2015).
doi: 10.1111/anae.13018
pubmed: 25772783
Ledowski, T. Objective monitoring of nociception: a review of current commercial solutions. Br. J. Anaesth. https://doi.org/10.1016/j.bja.2019.03.024 (2019).
doi: 10.1016/j.bja.2019.03.024
pubmed: 31759614
pmcid: 6676047
Storm, H. Changes in skin conductance as a tool to monitor nociceptive stimulation and pain. Curr. Opin. Anaesthesiol. 21, 796–804. https://doi.org/10.1097/ACO.0b013e3283183fe4 (2008).
doi: 10.1097/ACO.0b013e3283183fe4
pubmed: 18997532
Aslanidis, T., Grosomanidis, V., Karakoulas, K. & Chatzisotiriou, A. Electrodermal activity monitoring during painful stimulation in sedated adult intensive care unit patients: a pilot study. Acta Med. (Hradec Kralove) 61, 47–52. https://doi.org/10.14712/18059694.2018.50 (2018).
doi: 10.14712/18059694.2018.50
Aslanidis, T., Grosomanidis, V., Karakoulas, K. & Chatzisotiriou, A. Electrodermal activity monitoring during endotracheal suction in sedated adult intensive care unit patients. Folia Med. (Plovdiv) 60, 92–101. https://doi.org/10.1515/folmed-2017-0063 (2018).
doi: 10.1515/folmed-2017-0063
Storm, H., Gunther, A., Sackey, P. V., Bernhardsson, J. & Bjarta, A. Measuring pain-physiological and self-rated measurements in relation to pain stimulation and anxiety. Acta Anaesthesiol. Scand. 63, 668–675. https://doi.org/10.1111/aas.13323 (2019).
doi: 10.1111/aas.13323
pubmed: 30701545
Ledowski, T. et al. Monitoring of skin conductance to assess postoperative pain intensity. Br. J. Anaesth. 97, 862–865. https://doi.org/10.1093/bja/ael280 (2006).
doi: 10.1093/bja/ael280
pubmed: 17060329
Gunther, A. C. et al. Palmar skin conductance variability and the relation to stimulation, pain and the motor activity assessment scale in intensive care unit patients. Crit. Care 17, R51. https://doi.org/10.1186/cc12571 (2013).
doi: 10.1186/cc12571
pubmed: 23510014
pmcid: 3672492
Hansen, J. O. et al. Skin conductance as a pain assessment tool during chest tube removal: an observational study. Eur. J. Pain 21, 987–996. https://doi.org/10.1002/ejp.999 (2017).
doi: 10.1002/ejp.999
pubmed: 28207186
Hullett, B. et al. Monitoring electrical skin conductance: a tool for the assessment of postoperative pain in children?. Anesthesiology 111, 513–517. https://doi.org/10.1097/ALN.0b013e3181b27c18 (2009).
doi: 10.1097/ALN.0b013e3181b27c18
pubmed: 19672172
Ledowski, T. et al. The assessment of postoperative pain by monitoring skin conductance: results of a prospective study. Anaesthesia 62, 989–993. https://doi.org/10.1111/j.1365-2044.2007.05191.x (2007).
doi: 10.1111/j.1365-2044.2007.05191.x
pubmed: 17845649
Ledowski, T., Ang, B., Schmarbeck, T. & Rhodes, J. Monitoring of sympathetic tone to assess postoperative pain: skin conductance vs surgical stress index. Anaesthesia 64, 727–731. https://doi.org/10.1111/j.1365-2044.2008.05834.x (2009).
doi: 10.1111/j.1365-2044.2008.05834.x
pubmed: 19183409
Choo, E. K. et al. Skin conductance fluctuations correlate poorly with postoperative self-report pain measures in school-aged children. Anesthesiology 113, 175–182. https://doi.org/10.1097/ALN.0b013e3181de6ce9 (2010).
doi: 10.1097/ALN.0b013e3181de6ce9
pubmed: 20526184
Harrison, D. et al. Skin conductance as a measure of pain and stress in hospitalised infants. Early Hum. Dev. 82, 603–608. https://doi.org/10.1016/j.earlhumdev.2005.12.008 (2006).
doi: 10.1016/j.earlhumdev.2005.12.008
pubmed: 16507342
Czaplik, M. et al. Acute pain therapy in postanesthesia care unit directed by skin conductance: a randomized controlled trial. PLoS ONE 7, e41758. https://doi.org/10.1371/journal.pone.0041758 (2012).
doi: 10.1371/journal.pone.0041758
pubmed: 22848592
pmcid: 3407175
Treister, R., Kliger, M., Zuckerman, G., Goor Aryeh, I. & Eisenberg, E. Differentiating between heat pain intensities: the combined effect of multiple autonomic parameters. Pain 153, 1807–1814. https://doi.org/10.1016/j.pain.2012.04.008 (2012).
doi: 10.1016/j.pain.2012.04.008
pubmed: 22647429
Loggia, M. L., Juneau, M. & Bushnell, M. C. Autonomic responses to heat pain: heart rate, skin conductance, and their relation to verbal ratings and stimulus intensity. Pain 152, 592–598. https://doi.org/10.1016/j.pain.2010.11.032 (2011).
doi: 10.1016/j.pain.2010.11.032
pubmed: 21215519
Kain, Z. N., Sevarino, F., Alexander, G. M., Pincus, S. & Mayes, L. C. Preoperative anxiety and postoperative pain in women undergoing hysterectomy: a repeated-measures design. J. Psychosom. Res. 49, 417–422 (2000).
doi: 10.1016/S0022-3999(00)00189-6
Gaudry, E., Vagg, P. & Spielberger, C. D. Validation of the state-trait distinction in anxiety research. Multivar. Behav. Res. 10, 331–341. https://doi.org/10.1207/s15327906mbr1003_6 (1975).
doi: 10.1207/s15327906mbr1003_6
Hidano, T., Iwasaki, M., Soga, S., & Spielberger, C. D. State Trait Anxiety Inventory (Form JYZ) Test Manual (Japanese Adaptation of STAI). (2000).
Neziri, A. Y. et al. Factor analysis of responses to thermal, electrical, and mechanical painful stimuli supports the importance of multi-modal pain assessment. Pain 152, 1146–1155. https://doi.org/10.1016/j.pain.2011.01.047 (2011).
doi: 10.1016/j.pain.2011.01.047
pubmed: 21396782
Posner, J., Telekes, A., Crowley, D., Phillipson, R. & Peck, A. W. Effects of an opiate on cold-induced pain and the CNS in healthy volunteers. Pain 23, 73–82 (1985).
doi: 10.1016/0304-3959(85)90232-5
Chen, A. C., Dworkin, S. F., Haug, J. & Gehrig, J. Human pain responsivity in a tonic pain model: psychological determinants. Pain 37, 143–160 (1989).
doi: 10.1016/0304-3959(89)90126-7
Ogino, Y., Kakeda, T., Nakamura, K. & Saito, S. Dehydration enhances pain-evoked activation in the human brain compared with rehydration. Anesth. Analg. 118, 1317–1325. https://doi.org/10.1213/ANE.0b013e3182a9b028 (2014).
doi: 10.1213/ANE.0b013e3182a9b028
pubmed: 24384865
Ogino, Y. et al. Inner experience of pain: imagination of pain while viewing images showing painful events forms subjective pain representation in human brain. Cereb. Cortex 17, 1139–1146. https://doi.org/10.1093/cercor/bhl023 (2007).
doi: 10.1093/cercor/bhl023
pubmed: 16855007
Storm, H., Fremming, A., Odegaard, S., Martinsen, O. G. & Morkrid, L. The development of a software program for analyzing spontaneous and externally elicited skin conductance changes in infants and adults. Clin. Neurophysiol. Off. J. Int. Fed. Clin. Neurophysiol. 111, 1889–1898 (2000).
doi: 10.1016/S1388-2457(00)00421-1
Lautenschlager, G. et al. The impact of baroreflex function on endogenous pain control: a microneurography study. Eur. J. Neurosci. 42, 2996–3003. https://doi.org/10.1111/ejn.13096 (2015).
doi: 10.1111/ejn.13096
pubmed: 26454007
Storm, H. Why do similar studies conclude differently when they are performed with nearly the same protocol and the same skin conductance technology and on the same population of patients?. Anesthesiology 114, 464–465. https://doi.org/10.1097/ALN.0b013e31820704f8 (2011) (author reply 465–466).
doi: 10.1097/ALN.0b013e31820704f8
pubmed: 21266874
Ledowski, T., Albus, S., Stein, J. & Macdonald, B. Skin conductance for monitoring of acute pain in adult postoperative patients: influence of electrode surface area and sampling time. J. Clin. Monit. Comput. 25, 371–376. https://doi.org/10.1007/s10877-011-9314-0 (2011).
doi: 10.1007/s10877-011-9314-0
pubmed: 22037701
Valkenburg, A. J., Niehof, S. P., van Dijk, M., Verhaar, E. J. & Tibboel, D. Skin conductance peaks could result from changes in vital parameters unrelated to pain. Pediatr. Res. 71, 375–379. https://doi.org/10.1038/pr.2011.72 (2012).
doi: 10.1038/pr.2011.72
pubmed: 22391638
Ben-Israel, N., Kliger, M., Zuckerman, G., Katz, Y. & Edry, R. Monitoring the nociception level: a multi-parameter approach. J. Clin. Monit. Comput. 27, 659–668. https://doi.org/10.1007/s10877-013-9487-9 (2013).
doi: 10.1007/s10877-013-9487-9
pubmed: 23835792
Edry, R., Recea, V., Dikust, Y. & Sessler, D. I. Preliminary intraoperative validation of the nociception level index: a noninvasive nociception monitor. Anesthesiology 125, 193–203. https://doi.org/10.1097/ALN.0000000000001130 (2016).
doi: 10.1097/ALN.0000000000001130
pubmed: 27171828
Martini, C. H. et al. Ability of the nociception level, a multiparameter composite of autonomic signals, to detect noxious stimuli during propofol-remifentanil anesthesia. Anesthesiology 123, 524–534. https://doi.org/10.1097/ALN.0000000000000757 (2015).
doi: 10.1097/ALN.0000000000000757
pubmed: 26154185