title: Skin conductance as a measure of pain and stress in hospitalised infants.
abstract: BACKGROUND
  Reliable and valid methods of measuring pain responses in infants continue to be sought as a means of evaluating the effectiveness of pain reduction strategies. Skin conductance has recently been shown to be a promising physiological indicator of pain and stress in premature and term infants.
  
  
  OBJECTIVE
  To evaluate changes in skin conductance in hospitalised infants under different environmental conditions and during both painful and non-painful procedures.
  
  
  METHODS
  Measurements of skin conductance activity were made in infants under three different environmental temperature conditions (open cot, incubator and overhead radiant heater), during the routine non-painful nursing procedure of either nappy change or oral feeding, and whilst undergoing the painful procedure of heel lancing for blood sampling.
  
  
  RESULTS
  Skin conductance activity in 21 infants was studied on 43 separate occasions. Skin conductance activity was highly variable between infants but did not differ significantly under the three environmental conditions. Routine nursing care did not result in a significant increase in skin conductance activity above baseline; however, on cessation of care there was a significant reduction to levels below baseline (p < 0.05). Conversely, during the heel lance procedure, skin conductance activity significantly increased upon lance (p < 0.05) and remained elevated following completion of the procedure. There were no statistically significant differences between skin conductance activity changes from baseline as a result of routine nursing care compared to that of the heel lance procedure.
  
  
  CONCLUSIONS
  Due to large variability in skin conductance activity further studies are needed before this technology can be recommended as a clinically useful indicator of pain and stress in neonates.
authors.affiliation: Department of Neonatology, Royal Children's Hospital, Melbourne, Australia. denise.harrison@rch.org.au
authors.forename: Denise
authors.initials: D
authors.lastname: Harrison
authors.forename: Suzanne
authors.initials: S
authors.lastname: Boyce
authors.forename: Peter
authors.initials: P
authors.lastname: Loughnan
authors.forename: Peter
authors.initials: P
authors.lastname: Dargaville
authors.forename: Hanne
authors.initials: H
authors.lastname: Storm
authors.forename: Linda
authors.initials: L
authors.lastname: Johnston
mesh_terms: D005712:Galvanic Skin Response; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D009732:Nursing Care; D010147:Pain Measurement / Q000379:methods* / Q000451:nursing; D013312:Stress, Physiological / Q000175:diagnosis*