Feasibility of monitoring stress using skin conduction measurements during intubation of newborns.
Eur J Pediatr
; 175(2): 237-43, 2016 Feb.
Article
em En
| MEDLINE
| ID: mdl-26328787
ABSTRACT
The objective of this study was to assess the feasibility of monitoring stress responses in newborns during naso-tracheal intubation after two different premedication regimens, using skin conductance measurements (SCM). Twenty-two newborns were randomised and premedicated with morphine + vecuronium or propofol. SCM (peaks/s) were collected prior to, during and after the procedure. Threshold for interpreting responses as stressful was 0.21 peaks/s. Intubation conditions and physiological parameters were registered. Intubation conditions were good in all newborns. Administration of morphine (range 1.4-10.3 min) before administration of vecuronium did not affect SCM when a stressful stimulus was applied. Within 1.6 min (range 0.8-3 min) after administration of vecuronium, SCM disappeared in 10 of 11 newborns. Propofol reduced SCM in 10 of 11 newborns at the first attempt. Further attempts were associated with increasing SCM, mostly above a threshold of 0.21 peaks/s. There were no significant changes in physiological parameters during the procedure for either premedication regimen. CONCLUSION:
The variation in SCM between individual newborns limits the usefulness of SCM as stress monitor during intubation. The use of neuromuscular blockers for premedication precludes monitoring of SCM completely in newborns. WHAT IS KNOWN Skin conductance measurements have been used successfully to monitor pain in awake newborn infants. WHAT IS NEW Premedicated newborns display significant interindividual variation in skin conductance measurements during an intubation procedure. Neuromuscular blockade causes skin conductance measurements to disappear completely.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Dor
/
Pré-Medicação
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Estresse Fisiológico
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Sedação Profunda
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Resposta Galvânica da Pele
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Intubação Intratraqueal
Tipo de estudo:
Clinical_trials
Limite:
Humans
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Infant
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Newborn
Idioma:
En
Revista:
Eur J Pediatr
Ano de publicação:
2016
Tipo de documento:
Article
País de afiliação:
Holanda