Skin conductance variations compared to ABC scale for pain evaluation in newborns

Abstract

Objectives: To validate spontaneous skin conductance variations as a specific reliable mean to measure pain in full-term healthy newborns during heel stick, comparing it with the ABC scale. To compare oral sucrose to wrapping effectiveness for non-pharmacological analgesia during the same procedure.

Method: All recruited newborns (n = 158) underwent a heel stick for metabolic screening at 48 h of life with non-pharmacological analgesia by oral sucrose (group A) or wrapping (group B) according to randomization. Their pain was estimated by ABC scale score (standard method) and measured by skin conductance variations.

Results: A positive correlation was founded between peaks per sec measure and ABC score (r_s = 0.303, p < 0.005). ABC score in group A was lower than in group B (p < 0.001). Difference in mean ABC score among newborn subgroups treated by different nurses was not statistically significant for wrapping while it was significant for sucrose (p = 0.001).

Conclusions: Skin conductance measurement device is a reliable method to evaluate pain. Novel technological devices may be a useful support to clinical observation in this field. Oral sucrose is more effective than wrapping in reducing pain. Operators should be well periodically re-trained in performing non pharmacological analgesia during minor procedure on newborns.

• Analgesia
• newborn
• pain
• skin conductance
• sucrose

Acknowledgements

The authors thank the staff nurses, who performed heel sticks on recruited newborns: Anna Bozzi, Palma Fele, Francesco Gabbriellini, Diletta Iossa, Cristiana Matteini, Arianna Moretti, Vanessa Noirjean and Federica Paolicchi. This research was not either partially or totally economically supported by public institutions or private foundations. However, the authors also thank DMF srl, Dietetic Metabolic Food (Limbiate – MB, Milano, Italy – www.dmfmetabolic.it), which provided Baby Sucrose 24% for non-pharmacological analgesia and Medisize Italia Srl (www.medisize.com), which provided the Pain Monitor® device for skin conductance measurement.