title: Skin conductance peaks could result from changes in vital parameters unrelated to pain.
abstract: BACKGROUND
  Pain is usually assessed by the interpretation of behavior, which can be subjective. Therefore, there is an ongoing search for more objective methods. Performance of skin conductance measurement as a pain assessment tool is variable, as some studies report low specificity and a low predictive value of the method. The aim of this pilot study was to test whether autoregulation of the skin temperature influences the skin conductance of pain-free infants.
  
  
  RESULTS
  Skin conductance was highly correlated with skin temperature in all subjects. Moreover, a significant change in all other vital parameters was observed on comparing before- and after-peak data.
  
  
  CONCLUSIONS
  These results indicate that sympathetic neural activity to maintain homeostasis (such as autoregulation of skin temperature) results in skin conductance peaks. Real-time evaluation of the sympathetic nervous system would be valuable for pain assessment. However, the technique should be better defined to increase both sensitivity and specificity for the measurement of pain before use in daily practice can be advocated.
  
  
  METHODS
  We included 11 infants, median (interquartile range (IQR)) age of 34 (13-76) d, who were admitted to the surgical high-care unit for monitoring after surgery. None was treated with opioids or sedatives, and observational pain scores were low.
authors.affiliation: Department of Pediatric Surgery, Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands. a.valkenburg@erasmusmc.nl
authors.forename: Abraham J
authors.initials: AJ
authors.lastname: Valkenburg
authors.forename: Sjoerd P
authors.initials: SP
authors.lastname: Niehof
authors.forename: Monique
authors.initials: M
authors.lastname: van Dijk
authors.forename: Esther J M
authors.initials: EJ
authors.lastname: Verhaar
authors.forename: Dick
authors.initials: D
authors.lastname: Tibboel
mesh_terms: D005260:Female; D005712:Galvanic Skin Response / Q000502:physiology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010146:Pain; D010147:Pain Measurement / Q000379:methods*; D010149:Postoperative Pain; D010865:Pilot Projects; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D012881:Skin Temperature; D013564:Sympathetic Nervous System; D013997:Time Factors