Plasma B-Endorphin in Response to Wound Care

Pain is a major health care problem in the United States. Sixty million individuals annually seek health care for complaints of pain. Of these individuals, it has been estimated that almost 17% will suffer from pain that will persist to the extent that they will ultimately become disabled. Pain associated with acute injury or therapeutic interventions has been less than optimally identified by health care providers. One reason for the failure to identify the presence of pain in the acutely injured is that injured individuals may be either slow to respond or nonresponsive and thus unable to provide information regarding their perception of pain. Moreover, because pain associated with acute injury involves life-threatening alterations in both the psychologic and physiologic status of that individual, pain has been difficult to assess using the traditional techniques. Therefore, it is important that health care providers be able to assess pain in the acutely injured using measurements that do not rely on the patient's ability to provide subjective input. The long-term objective of this research program is to identify physiologic markers that may be used to identify the presence of pain in the acutely injured who are slow to respond or nonresponsive. The major goal of this research proposal is to identify the presence of plasma concentrations of -endorphin, an endogenous opoid-like substance, in response to wound care of thermally-degraded epithelial tissue when around-the-clock non-opoid analgesic medication is provided. Male Sprague-Dawley rats will be used for this study. The design is experimental and multifactoral with repeated measures. Analysis of Variance (ANOVA) will be performed followed by Tukey's HSD test for comparison of means and a simple main effect analysis. Correlations will also be computed. Although basic research will be conducted using a laboratory animal model for the wound care of thermally-degraded epithelial tissue, it is anticipated that the findings will advance nursing and medical science. The objective assessment of pain in acutely injured individuals poses an enormous challenge to health care providers. Hopefully, identification of an objective physiologic clinical marker of pain will lead to the development of new pain assessment strategies. New pain assessment strategies then may lead to optimal interventions for the control of pain and to timely implementation for acutely injured individuals who are compromised in their ability to respond.