OPTIMIZING CONTROL OF PAIN FROM SEVERE BURNS

优化控制严重烧伤引起的疼痛

• 批准号: 2181619
• 负责人: DAVID R PATTERSON
• 金额: $ 26.22万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 1990
• 资助国家: 美国
• 起止时间: 1990-04-01 至 1998-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2181619
• 关键词: adolescence (12-20); adult human (21+); analgesics; anxiety; burn therapy; burns; child (0-11); drug administration rate /duration; hospital patient care; human subject; human therapy evaluation; hypnosis; longitudinal human study; lorazepam; morphine; pain threshold; psychological adaptation; psychological tests; psychotherapy; stress; tranquilizer

The first broad, long-term objective of this project is to improve pain control in adults and children who are hospitalized for the care of severe burn injuries. This will be accomplished by determining the optimal doses of opioid drugs (e.g., morphine and its derivatives), and the types of adjunctive interventions (pharmacological, psychological) which have the greatest analgesic effect for particular patients. A second broad objective is to improve knowledge regarding the long-term psychological adjustment of people surviving severe burn injuries. The specific aims of the project with adult burn patients include testing 1) whether scores on psychometric tests predict response to lorazepam (i.e., the tranquilizer Ativan) and hypnosis, and 2) which variables predict long-term psychological adjustment. The specific aims for the pediatric burn population are 1) to gather better information about drug dosing for infants and toddlers and determine whether regular schedules of dosing are superior to as needed medication application, and 2) to compare psychological and pharmacological adjuncts for children aged 3-12. The implications of this project for health care include reducing unnecessary suffering from trauma, improving treatment outcome of burn injuries through reducing pain mediated stress, minimizing the financial burden of untreated pain, using burn pain as a model for other acute etiologies of pain,and improving quality of life after disability. To accomplish these objectives, four studies have been proposed involving adult and pediatric patients hospitalized for care at a regional, university based burn center. The first study is a continuation of current research and involves determining what psychometric measures best predict the analgesic response of adults who are randomly assigned to lorazepam or hypnosis treatment conditions. The second study will involve comparing whether infants and toddlers (ages birth - 3 years) randomized to groups which receive regular schedules of medication or "as needed" plans, show differences in observed behaviors indicative of pain. In the third study, burned children (aged 3-12 years) will be randomly assigned to conditions in which they receive psychological interventions or lorazepam for dressing change pain. Finally, the fourth study will involve a continuation of current research. Measures that predict long-term psychological outcome after burn injuries will be tested.

该项目的第一个宽阔的长期目标是改善痛苦 为了照顾严重的成人和儿童的控制 烧伤受伤。这将通过确定最佳剂量来实现 阿片类药物（例如吗啡及其衍生物）的类型 辅助干预措施（药理，心理学），具有 对特定患者的镇痛作用最大。第二宽 目的是提高有关长期心理的知识 调整存活严重烧伤伤害的人。具体目的 成人烧伤患者的项目包括测试1） 心理测试预测对劳拉西m的反应（即，镇静剂 ativan）和催眠，以及2）变量预测长期 心理调整。小儿燃烧的具体目的 人口是1）收集有关药物给药的更好信息 婴儿和幼儿，并确定定期剂量时间表是否为 优于所需的药物应用，以及2）比较 3-12岁儿童的心理和药理辅助手段。这 该项目对医疗保健的影响包括减少不必要的 患有创伤，改善烧伤受伤的治疗结果 通过减轻疼痛介导的压力，最大程度地减少 未经治疗的疼痛，使用烧伤疼痛作为其他急性病因的模型 痛苦，并改善残疾后生活质量。 为了实现这些目标，已经提出了四项研究 成人和儿科患者在一个地区住院治疗， 大学燃烧中心。第一个研究是当前的延续 研究并涉及确定哪些心理测量措施最好预测 被随机分配到劳拉西m或的成年人的镇痛反应 催眠治疗条件。第二项研究将涉及比较 婴儿和幼儿（年龄出生 - 3岁）是否随机分组 可以定期获得药物时间表或“根据需要”计划，显示 观察到的行为的差异表示疼痛。在第三项研究中， 被烧伤的儿童（3-12岁）将随机分配到条件 他们接受心理干预或劳拉西m 穿衣变化疼痛。最后，第四项研究将涉及 当前研究的延续。预测长期的措施 烧伤后的心理结果将被检查。