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Palmar skin conductance variability and the relation to stimulation, pain and the motor activity assessment scale in intensive care unit patients.

Günther AC, Bottai M, Schandl AR, Storm H, Rossi P, Sackey PV - Crit Care (2013)

Bottom Line: Patients were monitored with the MED-STORM Pain Monitoring System®.In non-intubated patients, NSCF increased with increasing stimulation/pain but also with higher MAAS (P=0.002).An interaction effect was found, with increased NSCF response to stimulation/pain with increasing MAAS (P<0.001).

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ABSTRACT

Introduction: Many intensive care unit (ICU) patients describe pain and other adverse feelings that may impact long-term psychological morbidity. Sympathetically mediated palmar skin conductance variability is related to emotionally induced perspiration and correlates with pain levels in the perioperative setting but has not been studied in ICU patients.

Methods: Twenty non-intubated and 20 intubated general ICU patients were included in this observational study. Patients were monitored with the MED-STORM Pain Monitoring System®. The number of skin conductance fluctuations per second (NSCF) was measured in parallel with bedside observation during one hour of intensive care, including rest, procedures and patient-staff interactions. Arousal-agitation level was monitored with the motor activity assessment scale (MAAS). Pain was monitored with the numeric rating scale (0 to 10) in patients able to communicate or by observation in patients unable to communicate.

Results: In non-intubated patients, NSCF increased with increasing stimulation/pain but also with higher MAAS (P=0.002). An interaction effect was found, with increased NSCF response to stimulation/pain with increasing MAAS (P<0.001).

Conclusions: In critically ill patients, NSCF may be more useful evaluating emotional distress rather than pain alone. It needs to be assessed whether NSCF monitoring is clinically useful and whether controlling emotional distress with the aid of such monitoring may impact on patient care and outcomes.

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Skin conductance variability (NSCF) in relation to stimulation and Motor Activity Assessment Scale, non-intubated patients.
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Figure 1: Skin conductance variability (NSCF) in relation to stimulation and Motor Activity Assessment Scale, non-intubated patients.

Mentions: In non-intubated patients, higher levels of stimulation/pain were associated with higher NSCF (P = 0.002) for all MAAS levels except MAAS 2 (Figure 1, Table 4). There was significant interaction between stimulation and MAAS level (P < 0.001), with an increased NSCF response to stimulation with increasing MAAS (Figure 1, Table 5).


Palmar skin conductance variability and the relation to stimulation, pain and the motor activity assessment scale in intensive care unit patients.

Günther AC, Bottai M, Schandl AR, Storm H, Rossi P, Sackey PV - Crit Care (2013)

Skin conductance variability (NSCF) in relation to stimulation and Motor Activity Assessment Scale, non-intubated patients.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3672492&req=5

Figure 1: Skin conductance variability (NSCF) in relation to stimulation and Motor Activity Assessment Scale, non-intubated patients.
Mentions: In non-intubated patients, higher levels of stimulation/pain were associated with higher NSCF (P = 0.002) for all MAAS levels except MAAS 2 (Figure 1, Table 4). There was significant interaction between stimulation and MAAS level (P < 0.001), with an increased NSCF response to stimulation with increasing MAAS (Figure 1, Table 5).

Bottom Line: Patients were monitored with the MED-STORM Pain Monitoring System®.In non-intubated patients, NSCF increased with increasing stimulation/pain but also with higher MAAS (P=0.002).An interaction effect was found, with increased NSCF response to stimulation/pain with increasing MAAS (P<0.001).

View Article: PubMed Central - HTML - PubMed

ABSTRACT

Introduction: Many intensive care unit (ICU) patients describe pain and other adverse feelings that may impact long-term psychological morbidity. Sympathetically mediated palmar skin conductance variability is related to emotionally induced perspiration and correlates with pain levels in the perioperative setting but has not been studied in ICU patients.

Methods: Twenty non-intubated and 20 intubated general ICU patients were included in this observational study. Patients were monitored with the MED-STORM Pain Monitoring System®. The number of skin conductance fluctuations per second (NSCF) was measured in parallel with bedside observation during one hour of intensive care, including rest, procedures and patient-staff interactions. Arousal-agitation level was monitored with the motor activity assessment scale (MAAS). Pain was monitored with the numeric rating scale (0 to 10) in patients able to communicate or by observation in patients unable to communicate.

Results: In non-intubated patients, NSCF increased with increasing stimulation/pain but also with higher MAAS (P=0.002). An interaction effect was found, with increased NSCF response to stimulation/pain with increasing MAAS (P<0.001).

Conclusions: In critically ill patients, NSCF may be more useful evaluating emotional distress rather than pain alone. It needs to be assessed whether NSCF monitoring is clinically useful and whether controlling emotional distress with the aid of such monitoring may impact on patient care and outcomes.

Show MeSH
Related in: MedlinePlus