Post-surgical Pain Assessment in Children: Roles of Skin Conductance and Genomics
| Status: | Recruiting |
|---|---|
| Conditions: | Chronic Pain |
| Therapuetic Areas: | Musculoskeletal |
| Healthy: | No |
| Age Range: | Any - 3 |
| Updated: | 3/15/2019 |
| Start Date: | September 2015 |
| End Date: | August 2020 |
| Contact: | Priti Dalal, MD |
| Email: | pdalal@hmc.psu.edu |
| Phone: | 7175314202 |
Pain assessment in infants and toddlers is quite challenging since children in these
populations are nonverbal or preverbal and cannot describe the presence and severity of pain
that they perceive. Over the last decade, advances in the field have included the development
of behavioral scoring systems for the assessment of acute pain . However, although they have
been validated, these commonly used methods of pain assessment are largely subjective and
rely on a highly trained observer. An objective continuous measure of pain would be an
important addition to standard behavioral painscores which require nurses to monitor the
child's behavioral responses.
populations are nonverbal or preverbal and cannot describe the presence and severity of pain
that they perceive. Over the last decade, advances in the field have included the development
of behavioral scoring systems for the assessment of acute pain . However, although they have
been validated, these commonly used methods of pain assessment are largely subjective and
rely on a highly trained observer. An objective continuous measure of pain would be an
important addition to standard behavioral painscores which require nurses to monitor the
child's behavioral responses.
After standard general anesthetic mask induction, 0.5 ml of blood will be drawn for genetic
analysis when the intravenous catheter is sited. A member of the research team will manually
transport an appropriately-labeled blood collection tube to the Department of Anesthesiology
Perioperative Genomics Laboratory for storage and further preparation for genetic analysis.
The samples will be stored until the investigators have enough to process. The results will
be stored in a secure database. The surgical procedure, anesthesia technique, intraoperative
analgesia treatment and initial postoperative analgesia treatment will be standardized.Upon
arrival in the Post-Anesthesia Care Unit(PACU), the child will be connected to standard
monitors as per standard of care. Pain scores will be recorded on a scale of 0-10 (FLACC,
Face, legs,activity, cry, consolability scale) scale. A member of the research team will
apply the skin conductance (SC) monitor on the child's hand or foot.This will be used to
measure SC values that will be saved on a laptop computer and the SC data will be analyzed
off-line.
analysis when the intravenous catheter is sited. A member of the research team will manually
transport an appropriately-labeled blood collection tube to the Department of Anesthesiology
Perioperative Genomics Laboratory for storage and further preparation for genetic analysis.
The samples will be stored until the investigators have enough to process. The results will
be stored in a secure database. The surgical procedure, anesthesia technique, intraoperative
analgesia treatment and initial postoperative analgesia treatment will be standardized.Upon
arrival in the Post-Anesthesia Care Unit(PACU), the child will be connected to standard
monitors as per standard of care. Pain scores will be recorded on a scale of 0-10 (FLACC,
Face, legs,activity, cry, consolability scale) scale. A member of the research team will
apply the skin conductance (SC) monitor on the child's hand or foot.This will be used to
measure SC values that will be saved on a laptop computer and the SC data will be analyzed
off-line.
Inclusion Criteria:
- Children 0 - 3 years of age inclusive
- Presenting for palatal repair (palatoplasty)
- American Society of Anesthesiologists (ASA) physical status of 1 or 2
Exclusion Criteria:
- Children > 3 years of age
- On chronic pain treatment
- Pre-operative use of analgesics
- Allergies to any anesthetics or analgesia products
- Known obstructive sleep apnea
- Diagnosis of Cystic fibrosis
- American Society of Anesthesiologists (ASA) physical status ≥ 3
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