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Preterm infants at high risk for retinopathy of prematurity (ROP) should undergo regular retinal examinations, which may be painful. Assessing pain accurately in newborns continues to be a challenge, and there is a need for more objective and reliable tools. The aim of our study was to evaluate the changes in skin conductance (SC) during eye examinations conducted for ROP screening and to study their association with changes in heart rate and oxygen saturation. We carried out a prospective observational study from January to May 2017. We included infants born at 32 or fewer weeks’ gestation that were candidates for retinal screening according to national guidelines. We used both pharmacological and nonpharmacological pain relief measures, including swaddling, facilitated tucking, a quiet environment, oral paracetamol, sucrose, non-nutritive sucking and topical anaesthetic drops. We measured skin conductance with a Med-Storm ® monitor (Med-storm Innovation; Oslo, Norway) and a 3-electrode system applied to the sole of the foot. We recorded the number of SC fluctuations per second (NSCF) in peaks/sec. More extensive descriptions of the SC monitor and the NSCF have been published previously. We recorded the maximum NSCF at 4 predefined time points: baseline, at placement of the lid speculum, at scleral indentation and at the end of the procedure. We also recorded all episodes of tachycardia (>180 bpm), bradycardia (<100 bpm) and oxygen desaturation (saturation < 85% for >10 s). The analysis included a maximum of 3 examinations per patient. We obtained the written consent of the parents, and the

La conductancia de la piel para evaluar el dolor y el estrés durante el cribado de la retinopatía de la prematuridad