Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2020.06.013
Brazilian Journal of Anesthesiology
Clinical Research

The effect of emotional stressors on postoperative skin conductance indices: a prospective cohort pilot study

Efeito dos estressores emocionais nos índices de condutância cutânea no pós-operatório: estudo piloto de coorte prospectivo

Semih Gungor, Hanne Storm, James J. Bae, Valeria Buschiazzo, Paul J. Christos

Downloads: 0
Views: 1098

Abstract

Background
Skin conductance response reflects the activity of the sympathetic nervous system and is used to measure acute pain. This pilot study examines correlations of skin conductance response with emotional stressors postoperatively.

Methods
The correlation of skin conductance response with pain, anxiety, nausea and intellectual task performance was analyzed in postoperative patients.

Results
Significant correlations were observed between anxiety and pain during physical activity on both postoperative day 1 and 2. No significant correlations were found between skin conductance response versus mild pain, nausea, anxiety or intellectual task performance.

Conclusion
This pilot study suggests that when the pain is well-controlled in the early postoperative period, skin conductance response monitoring may not be influenced by other emotional stressors.

Keywords

Emotional stressors;  Intellectual task;  Postoperative pain;  Skin conductance

Resumo

Justificativa
A variação da condutância da pele reflete a atividade do sistema nervoso simpático e é usada para avaliar dor aguda. Este estudo piloto examinou as correlações entre a variação da condutância da pele e estressores emocionais no pós-operatório.

Método
A correlação entre a variação da condutância da pele e dor, ansiedade, náusea e desempenho de tarefa intelectual foi analisada em pacientes no pós-operatório.

Resultados
Correlações significantes foram observadas entre ansiedade e dor durante atividade física nos dias 1 e 2 pós-operatórios. Não foram encontradas correlações significantes entre a variação da condutância da pele e dor leve, náusea, ansiedade ou desempenho de tarefa intelectual.

Conclusão
Este estudo piloto sugere que, quando a dor é bem controlada no pós-operatório inicial, o monitoramento empregando a variação da condutância da pele pode não ser influenciado por outros estressores emocionais.

Palavras-chave

Estressores emocionais;  Tarefa intelectual;  Dor pós-operatória;  Condutância da pele

References

1. Vila H, Jr., Smith RA, Augustyniak MJ, et al. The efficacy and safety of pain management before and after implementation of hospital-wide pain management standards: is patient safety compromised by treatment based solely on numerical pain ratings? Anesth Analg. 2005;101:474-80, table of contents.

2. Overdyk F, Carter R, Maddox R. New JCAHO pain standard bigger threat to patient safety than envisioned. Anesth Analg. 2006;102:1596; author reply 1596-1597.

3. Ferreira-Valente MA, Pais-Ribeiro JL, Jensen MP. Validity of four pain intensity rating scales. Pain. 2011;152:2399-404.

4. Liden Y, Landgren O, Arner S, et al. Procedure-related pain among adult patients with hematologic malignancies. Acta Anaesthesiol Scand.. 2009;53:354-63.

5. Kunimoto M, Kirno K, Elam M, et al. Neuroeffector characteristics of sweat glands in the human hand activated by regular neural stimuli. J Physiol. 1991;442:391-411.

6. Burton AR, Birznieks I, Bolton PS, et al. Effects of deep and superficial experimentally induced acute pain on muscle sympathetic nerve activity in human subjects. J Physiol. 2009;587:183-93.

7. Dube AA, Duquette M, Roy M, et al. Brain activity associated with the electrodermal reactivity to acute heat pain. NeuroImage. 2009;45:169-80.

8. Ledowski T, Bromilow J, Paech MJ, et al. Monitoring of skin conductance to assess postoperative pain intensity. Br J Anaesth. 2006;97:862-5.

9. Ledowski T, Bromilow J, Wu J, et al. The assessment of postoperative pain by monitoring skin conductance: results of a prospective study. Anaesthesia. 2007;62:989-93.

10. Liu SS, Bae JJ, Bieltz M, Wukovits B, Ma Y. A prospective survey of patient-controlled epidural analgesia with bupivacaine and clonidine after total hip replacement: a pre-and postchange comparison with bupivacaine and hydromorphone in 1,000 patients. Anesth Analg. 2011;113:1213-7

11. Storm H. Changes in skin conductance as a tool to monitor nociceptive stimulation and pain. Curr Opin Anesthesio. 2008;21:796-804.

12. Krenk L, Jennum P, Kehlet H. Activity, sleep and cognition after fast-track hip or knee arthroplasty. J Arthroplasty. 2013;28:1265-9.

13. Storm H, Fremming A, Odegaard S, et al. The development of a software program for analyzing spontaneous and externally elicited skin conductance changes in infants and adults. Clin Neurophysiol. 2000;111:1889-98.

14. Storm H, Gunther A, Sackey PV, et al. Measuring pain-Physiological and self-rated measurements in relation to pain stimulation and anxiety. Acta Anaesthesiol Scand. 2019;63:668-75.

15. Hansen JO, Storm H, Boglino-Horlin A, et al. Skin conductance as a pain assessment tool during chest tube removal: an observational study. Eur J Pain. 2017;21:987-96.

16. Bristow T, Jih CS, Slabich A, et al. Standardization and adult norms for the sequential subtracting tasks of serial 3's and 7's. Appl Neuropsychol Adult. 2016;23:372-8.

17. Greene NM. Area of differential block in spinal anesthesia with hyperbaric tetracaine. Anesthesiology. 1958;19:45-50.

18. Butterworth J. Physiology of spinal anesthesia: what are the implications for management? Reg Anesth Pain Med. 1998;23:370-3; discussion 384-377.

19. Gjerstad AC, Wagner K, Henrichsen T, et al. Skin conductance versus the modified COMFORT sedation score as a measure of discomfort in artificially ventilated children. Pediatrics. 2008;122:e848-853.

20. Gunther AC, Bottai M, Schandl AR, Storm H, Rossi P, Sackey PV. Palmar skin conductance variability and the relation to stimulation, pain and the motor activity assessment scale in intensive care unit patients. Critical care (London, England). 2013;17:R51.

21. Hullett B, Chambers N, Preuss J, Zamudio I, Lange J, Pascoe E, et al. Monitoring electrical skin conductance: a tool for the assessment of postoperative pain in children? Anesthesiology. 2009;111:513-7.

22. Aslanidis T, Grosomanidis V, Karakoulas K, Chatzisotiriou A. Electrodermal Activity Monitoring during Endotracheal Suction in Sedated Adult Intensive Care Unit Patients. Folia Med. 2018;60:92-101.

23. Storm H, Myre K, Rostrup M, Stokland O, Lien MD, Raeder JC. Skin conductance correlates with perioperative stress. Acta Anaesthesiologica Scandinavica. 2002;46:887-95.

24. Ellis RA. Eccrine Sweat Glands: Electron Microscopy, Cytochemistry and Anatomy. In: Achten G, Brody I, Braun-Falco O, Cramer HJ, Dotzauer G, Eberhartinger C, et al., eds. Normale und Pathologische Anatomie der Haut I. Berlin, Heidelberg: Springer Berlin Heidelberg; 1968. 224-266.

25. Bini G, Hagbarth KE, Hynninen P, Wallin BG. Thermoregulatory and rhythm-generating mechanisms governing the sudomotor and vasoconstrictor outflow in human cutaneous nerves. J Physiol. 1980;306:537-52.

26. Patterson JC, 2nd, Ungerleider LG, Bandettini PA. Task-independent functional brain activity correlation with skin conductance changes: an fMRI study. NeuroImage. 2002;17:1797-806.

27. McCracken LM, Gross RT, Sorg PJ, Edmands TA. Prediction of pain in patients with chronic low back pain: effects of inaccurate prediction and pain-related anxiety. Behav Res Ther. 1993;31:647-52.

28. Bengtsson M, Lofstrom JB, Malmqvist LA. Skin conductance responses during spinal analgesia. Acta Anaesthesiologica Scandinavica. 1985;29:67-71.

29. Lofstrom JB, Malmqvist LA, Bengtsson M. Can the "sympatho-galvanic reflex" (skin conductance response) be used to evaluate the extent of sympathetic block in spinal analgesia? Acta Anaesthesiol Scand. 1984;28:578-82.

5ef4e2c60e8825ce6a126526 rba Articles
Links & Downloads

Braz J Anesthesiol

Share this page
Page Sections