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首页> 外文期刊>Current opinion in anaesthesiology >Changes in skin conductance as a tool to monitor nociceptive stimulation and pain.
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Changes in skin conductance as a tool to monitor nociceptive stimulation and pain.

机译：皮肤电导的变化可作为监测伤害性刺激和疼痛的工具。

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PURPOSE OF REVIEW: The skin conductance algesimeter (SCA) reflects the sympathetic nervous system influenced by changes in emotions, which releases the acetylcholine that acts on muscarine receptors, causing a subsequent burst of sweat and increased skin conductance. The SCA reacts immediately and is not influenced by hemodynamic variability or neuromuscular blockade. The use of SCA for pain and nociceptive assessment is outlined in this review. RECENT FINDINGS: When pain was monitored by verbal reporting in postoperative patients, the SCA had a sensitivity of about 90% and specificity up to 74% to identify the pain, better than heart rate and blood pressure. In general anesthetized patients, both the sensitivity and specificity were about 90% to detect responses to noxious stimulation when compared with clinical stress variables. The SCA reflects changes in norepeinephrine levels induced by nociception better than heart rate, blood pressure, and electroencephalograph (EEG) monitors. Unlike EEG monitors, the SCA response is sensitive to experimental noxious stimuli during general anesthesia, and the measured response was attenuated by analgesic medication. This SCA response is significantly associated with genetically modulated pain sensitivity. Moreover, noxious stimuli in artificially ventilated patients and in preterm infants increase the SCA index, and the increase correlates to the clinical discomfort. SUMMARY: The SCA detects nociceptive pain fast and continuously, specific to the individual, with higher sensitivity and specificity than other available objective methods.
机译：审查目的：皮肤电导测痛计（SCA）反映了受情绪变化影响的交感神经系统，释放出作用于毒蕈碱受体的乙酰胆碱，导致随后的汗水爆发和皮肤电导增加。 SCA立即反应，不受血流动力学变异性或神经肌肉阻滞的影响。这篇综述概述了SCA在疼痛和伤害感受评估中的应用。最近的发现：当通过口头报告对术后患者进行疼痛监测时，SCA能够识别疼痛的敏感性约为90％，特异性高达74％，优于心率和血压。与临床压力变量相比，在全身麻醉的患者中，检测有害刺激反应的敏感性和特异性均约为90％。 SCA比心率，血压和脑电图（EEG）监测器更好地反映了由伤害感受引起的去甲肾上腺素水平的变化。与EEG监护仪不同，SCA响应对全身麻醉期间的实验性有害刺激敏感，而所测量的响应因止痛药而减弱。这种SCA反应与基因调节的疼痛敏感性显着相关。此外，在人工通气患者和早产儿中，有害刺激会增加SCA指数，并且这种增加与临床不适有关。简介：与其他可用的客观方法相比，SCA快速且连续地检测到特定于个体的伤害性疼痛，并且具有更高的灵敏度和特异性。

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