title: Acute pain therapy in postanesthesia care unit directed by skin conductance: a randomized controlled trial.
abstract: BACKGROUND
  After surgery, effective and well-directed acute pain therapy is a necessary and integral part of the overall treatment plan. Generally, the assessment of pain intensity depends on a patient's self-evaluation using scoring systems such as numeric rating scales (NRS, 0 to 10). Recently, a "Pain Monitor" was commercially provided which is based on measurements of fluctuations of skin conductance (NFSC). In this randomized, controlled, single-blind trial, possible benefits of this certain device were studied.
  
  
  METHODS
  Postoperative patients (n = 44) were randomly assigned to a test or a control group during their stay in the postanesthesia care unit (PACU). All patients were treated and monitored according to internal hospital standards. Whereas all patients systematically evaluated their pain each 15 min, test group patients were additionally addressed when NFSC exceeded a predefined level. In cases of NRS≥5 during a routine elevation or in between, pain relief was achieved by standard procedures irrespective of group allocation.
  
  
  RESULTS
  During their stay in PACU, both test and control groups experienced a significant decrease in NRS as a consequence of pain therapy. No significant differences in mean NRS or in NFSC values were found between the test and control groups. No correlation was observed between NRS and NFSC.
  
  
  CONCLUSIONS
  Postoperative patients experience diverse stressors, such as anxiety, disorientation, shivering, sickness and pain. Although the application of continuous pain monitoring would be meaningful in this clinical setting, the tested device failed to distinguish pain from other stressors in postoperative adult patients.
  
  
  BACKGROUND
  German Clinical Trials Register DRKS00000755.
authors: Department of Anesthesiology, University Hospital Aachen, Aachen, Germany. mczaplik@ukaachen.de
authors: Michael
authors: M
authors: Czaplik
authors: Christa
authors: C
authors: Hübner
authors: Markus
authors: M
authors: Köny
authors: Julia
authors: J
authors: Kaliciak
authors: Fatima
authors: F
authors: Kezze
authors: Steffen
authors: S
authors: Leonhardt
authors: Rolf
authors: R
authors: Rossaint
mesh_terms: D059787:Acute Pain / Q000209:etiology / Q000628:therapy*; D000328:Adult; D000758:Anesthesia; D005260:Female; D005712:Galvanic Skin Response; D006801:Humans; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement / Q000295:instrumentation*; D011182:Postoperative Care / Q000295:instrumentation / Q000379:methods*