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However, analgosedation for LISA remains controversial. The aim of this study was to assess pain using skin conductance (SC) measurements during LISA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective cohort study included preterm infants born at \u226527 weeks. Pain was assessed using SC and blinded Neonatal Pain, Agitation and Sedation Scale (N-PASS) scoring. Primary outcome was change to baseline in SC peaks per second (PPS) at pre-specified events. Secondary outcomes included N-PASS scores and changes in cardiorespiratory parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twenty infants were included in the analysis. SC-PPS were increased during nasopharyngeal tube (NPT) insertion, but no more significant after adjusting for chronological age. SC-PPS were not increased at any other pre-specified event during LISA. N-PASS scores indicated elevated pain levels during NPT insertion (\u0394\n                      <jats:sub>logit<\/jats:sub>\n                      = 3.28, 95%-CI: 1.37 to 5.20) and laryngoscopy (\u0394\n                      <jats:sub>logit<\/jats:sub>\n                      = 3.60, 95%-CI 1.77 to 5.43). SC and N-PASS scores showed a weak correlation (Kendall\u2019s \u03c4\n                      <jats:sub>B<\/jats:sub>\n                      \u2009=\u20090.17; 95%-CI: 0.02 to 0.31).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>LISA was not associated with elevated SC-PPS, despite increased N-PASS scores during specific procedural steps. This may reflect technical limitations of SC monitoring immediately after birth in preterm infants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial Registration:<\/jats:title>\n                    <jats:p>ClinicalTrials.gov (NCT06150586)<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Impact<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>Skin conductance (SC) measurement has been proposed as an objective method for pain assessment in preterm infants. In our study, SC did not indicate a pain response in infants undergoing Less Invasive Surfactant Administration (LISA).<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Our findings suggest that SC alone may not be a reliable indicator of procedural pain in preterm infants shortly after birth.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>There remains a critical need for objective methods to assess pain in preterm infants. Further research is required to validate SC for neonatal pain assessment.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1038\/s41390-025-04703-9","type":"journal-article","created":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T13:18:26Z","timestamp":1766409506000},"page":"913-919","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pain Assessment During Less Invasive Surfactant Administration Using Skin Conductance: A Prospective Cohort Study"],"prefix":"10.1038","volume":"100","author":[{"given":"Coralie","family":"Dirler","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6895-4861","authenticated-orcid":false,"given":"Vinzenz","family":"Boos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk","family":"Bassler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Benke-Bruderer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrike","family":"Held","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph M.","family":"R\u00fcegger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8661-9645","authenticated-orcid":false,"given":"Tobias","family":"Muehlbacher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,12,22]]},"reference":[{"key":"4703_CR1","doi-asserted-by":"publisher","first-page":"474","DOI":"10.1136\/archdischild-2020-319763","volume":"106","author":"I Bellos","year":"2021","unstructured":"Bellos, I., Fitrou, G., Panza, R. & Pandita, A. 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