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BJA Advance Access published online on October 22, 2006
British Journal of Anaesthesia, doi:10.1093/bja/ael280
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org
Accepted July 15, 2006

Clinical Investigation

Monitoring of skin conductance to assess postoperative pain intensity

T. Ledowski 1 *, J. Bromilow 1, M. J. Paech 2, H. Storm 3, R. Hacking 1, and S. A. Schug 2

1 Department of Anaesthesia and Pain Medicine, Royal Perth Hospital, Wellington Street Campus, Perth WA 6000, Australia
2 School of Medicine and Pharmacology, The University of Western Australia, Perth, Australia
3 Skills Training Centre, Rikshospitalet, University Hospital, University of Oslo, Norway

* To whom correspondence should be addressed.
T. Ledowski, E-mail: thomas.ledowski{at}health.wa.gov.au


  Abstract

Background. Pain is known to alter the electrogalvanic properties of the skin. The aim of this pilot study was to investigate the influence of postoperative pain on skin conductance (SC) readings.

Methods. After obtaining ethical approval and written informed consent, 25 postoperative patients were asked to quantify their level of pain on a numeric rating scale (NRS, 0-10) at different time points in the recovery room. As a parameter of SC, the number of fluctuations within the mean SC per second (NFSC) was recorded. Simultaneously, the NRS was obtained from patients by a different observer who was blinded to the NFSC values.

Results. Data from 110 readings of 25 patients (14 female, 11 male; 21-67 yr) were included. NFSC showed a significant correlation with the NRS (r=0.625; P<0.01), whereas heart rate and blood pressure showed no or very weak correlation with the NRS. NFSC was significantly different between patients with no (NRS=0), mild (NRS=1-3), moderate (NRS=4-5) and severe (NRS=6-10) pain (no: 0.047, mild: 0.089, moderate: 0.242, severe: 0.263; P<0.0001). Post hoc, a cut-off value for NFSC (0.1) was calculated above which a pain score >3 on the NRS was predicted with sensitivity of 89% and specificity of 74%.

Conclusions. The severity of postoperative pain significantly influences SC. Using cut-off values, NFSC may prove a useful tool for pain assessment in the postoperative period.

Keywords: pain, postoperative; measurement techniques, skin conductance; recovery, postoperative.
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