Abstract
Skin conductance monitoring is one of the promising methods for objectively evaluating pain. However, skin conductance might possibly increase in response to sympathetic stimulation other than pain. In this study, we aimed to test whether skin conductance monitoring can distinguish physical pain stimulation (heat, mechanical and cold stimulation) from other sympathetic stimuli (stimulation by noise and painful images). Twenty-three healthy volunteers participated in this prospective observational study. The number of fluctuations in skin conductance (NFSC) and normalized skin conductance level (nSCL) were measured and compared with pain scores on a self-reported pain scale (numerical pain scale [NPS]). Both NFSC and nSCL increased during mechanical stimulation. Further, nSCL, but not NFSC, well reflected heat stimulus intensity, suggesting its ability to quantitatively evaluate pain. nSCLs during physical pain stimulation were greater than those during other sympathetic stimulations. However, NFSC was not able to completely distinguish between the stimuli. These results suggest that nSCL could better differentiate physical pain stimuli from other sympathetic stimuli than NFSC. In comparisons between subjective and objective pain assessment in the same individual, nSCL correlated better with NPS score, indicating the possibility of being able to monitor the transition of pain. Monitoring changes in skin conductance using nSCL might be useful for objectively detecting physical pain.
Highlights
Skin conductance monitoring is one of the promising methods for objectively evaluating pain
The only difference in unpleasantness scores was that between control (32 °C) stimulation and all other stimuli (P < 0.05, one-way analysis of variance (ANOVA) with post-hoc Student–Newman–Keuls test)
NSCLs during physical pain stimulation were greater than those during other sympathetic stimulations (Fig. 3c, d, P < 0.05, one-way ANOVA post hoc Student–Newman–Keuls test). These results suggest that normalized skin conductance level (nSCL) could better differentiate the common physical pain stimuli from other sympathetic stimuli than number of fluctuations in skin conductance (NFSC)
Summary
Skin conductance monitoring is one of the promising methods for objectively evaluating pain. The number of fluctuations in skin conductance (NFSC) and normalized skin conductance level (nSCL) were measured and compared with pain scores on a self-reported pain scale (numerical pain scale [NPS]). Both NFSC and nSCL increased during mechanical stimulation. Monitoring changes in skin conductance using nSCL might be useful for objectively detecting physical pain. Psychometric response scales, such as the visual analogue scale, have been widely used for assessment of p ain[1]. NFSC reportedly increased in response to painful s timuli[7,8] and well reflected pain
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