BETA ENDORPHIN LEVELS IN BURNED PATIENTS.

Abstract

Nursing activities directed at maintaining patient comfort incorporates time and energy. Nurses and researchers continue to search for adequate methods and information to quantify pain. The common mode of therapy is the administration of narcotics, which do not consistently relieve the pain described by traumatically injured patients. Discovery of endogenous opiates, such as β-endorphins, provided the potential for acquiring additional physiologic information regarding neuro-endocrine activities associated with pain. Consistent findings of concentrated β-endorphins in areas of the central nervous system previously identified as pain pathways prompted clinical researchers to determine β-endorphin levels in patients experiencing pain. The purposes of this investigation were to study β-endorphin levels in burn injured patients by describing: (1) the pattern of β-endorphin levels in burn injured patients during the first two weeks following injury, (2) the relationship between β-endorphin levels and the severity of the burn injury, (3) the relationship between analgesia taken by patients and the severity of the burn, and (4) the relationship between β-endorphin levels and the amount of analgesia given to the burn patient. Plasma samples for β-endorphin levels were obtained from 28 burned patients over a two-week interval. New England Nuclear ¹²⁵I β-Endorphin Kits were used to assay the plasma samples. In addition, information was tabulated from the patient's chart to complete the Burn Severity Index. Narcotic analgesia taken 24 hours before obtaining the blood sample were summarized and categorized according to the Equianalgesia Table. Descriptive and correlational statistics showed no significant relationships between β-endorphins over time, β-endorphins with burn severity, β-endorphins with the analgesia equivalency score, or burn severity with the analgesia equivalency scores. β-endorphin levels were elevated above normal in all 28 patients. Five patients displayed the anticipated declining pattern over the two-week interval post burn. Many erratic peaks and troughs in β-endorphin levels were observed with some peaks associated with clinical events. The findings of elevated β-endorphin levels have implications for nursing practice and provide stimulus for continued nursing research.