• M J Solana, J Lopez-Herce, S Fernandez, R Gonzalez, J Urbano, J Lopez, and J M Bellon.
• Pediatric Intensive Care Service, Hospital General Universitario Gregorio Marañón, Dr Castelo 47, 28009 Madrid, Spain; Instituto de Investigación del Hospital Gregorio Marañón, Doctor Esquerdo 46, 28009 Madrid, Spain. Electronic address: mjsolana@hotmail.com.
• J Crit Care. 2015 Jun 1;30(3):481-5.

PurposeThe purpose of this study is to assess the usefulness and accuracy of skin conductance (SC) as a tool to evaluate the level of sedation and pain in pediatric critical patients during painful procedures and to compare it with hemodynamic variables, clinical scales, and bispectral index (BIS).Materials And MethodsThis is a prospective observational study in 61 critical children undergoing invasive procedures. Hemodynamic data (heart rate and arterial blood pressure), clinical scales punctuation (Ramsay, COMFORT, and numeric rating pain scales), BIS, and the number of fluctuations of SC per second were collected before, during, and at the end of the procedure.ResultsThe mean age of the patients was 42.9 (range, 1 month to 16 years). Seventy-two point six percent were postcardiac surgery patients. Nonmuscle-relaxed patients showed a moderate increase in heart rate (P = .02), numeric rating pain scales (P = .03), and Ramsay scale (P = .002). The number of fluctuations of SC per second increased significantly during the procedure (basal, 0.1; maneuver, 0.2; P = .015), but it never reached the level considered as pain or stress nor did it precede clinical scales or BIS. None of the variables studied showed a significant change during the procedure in muscle-relaxed patients.ConclusionsSkin conductance was not found to be more sensitive or faster than clinical scales for the assessment of pain or stress in critical children undergoing painful procedures. Skin conductance was not useful in muscle-relaxed children.Copyright © 2015 Elsevier Inc. All rights reserved.

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