Pain assessment during eye examination for retinopathy of prematurity screening: Skin conductance versus PIPP‐R

• Published in: Acta Paediatrica Vol. 109; no. 5; pp. 935 - 942
• Main Authors: Avila‐Alvarez, Alejandro, Pertega‐Diaz, Sonia, Vazquez Gomez, Lorena, Sucasas Alonso, Andrea, Romero Rey, Henar, Eiriz Barbeito, Dolores, Cabana Vazquez, Montserrat
• Format: Journal Article
• Language: English
• Published: Norway Wiley Subscription Services, Inc 01.05.2020
• Subjects: Conductance; Eye examinations; Humans; Infant; Infant, Newborn; Infant, Premature; Neonates; Pain; Pain - diagnosis; Pain - etiology; Pain Measurement; Physical Examination; premature infants; Retina; Retinopathy; retinopathy of prematurity; Retinopathy of Prematurity - diagnosis; Skin; skin conductance; stress; premature infants; stress; pain; skin conductance; retinopathy of prematurity
• ISSN: 0803-5253; 1651-2227
• DOI: 10.1111/apa.15066

Aim To assess changes in skin conductance during retinopathy of prematurity screening and to study the correlation between the skin conductance and a validated pain scale. Methods Prospective observational study. Fifty‐three eye examinations were performed in 32 preterm infant candidates for retinopathy of prematurity screening. Outcome measures were changes in Premature Infant Pain Profile‐Revised (PIPP‐R) scale and number of skin conductance fluctuations. Results There was a significant increase from baseline in the number of skin conductance fluctuations and PIPP‐R during the procedure. The maximum value of number of skin conductance fluctuations was 0.64 ± 0.44 peaks/sec, and the maximum value of PIPP‐R was 10.8 ± 3.3. A correlation between the skin conductance and PIPP‐R was not found at any time during the eye examination. Repeated measures correlation analyses showed only a moderate positive correlation between PIPP‐R and number of skin conductance fluctuation values. Conclusion There were significant changes in both PIPP‐R and number of skin conductance fluctuations during retinopathy of prematurity screening, reaffirming that this procedure is painful and stressful. The number of skin conductance fluctuations and PIPP‐R are not significantly correlated, which likely reflects that these parameters evaluate different but complementary aspects of neonatal pain responses.