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Related Concept Videos

Analgesia and Pain Management01:25

Analgesia and Pain Management

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Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
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Opioid Analgesics: Morphine and Other Natural Cogeners01:20

Opioid Analgesics: Morphine and Other Natural Cogeners

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Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
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Opioid Receptors: Overview01:22

Opioid Receptors: Overview

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Opioid receptors, including the mu (μ, MOR), delta (δ, DOR), and kappa (κ, KOR) types, belong to the rhodopsin family of G protein-coupled receptors. These receptors are located throughout the central and peripheral nervous systems and in non-neuronal tissues such as macrophages and astrocytes. Opioid receptor ligands can be categorized into agonists or antagonists. Highly selective agonists include [d-Ala2, MePhe4, Gly(ol)5]-enkephalin or DAMGO for MOR, [D-Pen2,...
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Opioid Analgesics: Synthetic and Semisynthetic Opioids01:15

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Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
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Nociception01:44

Nociception

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Nociception—the ability to feel pain—is essential for an organism’s survival and overall well-being. Noxious stimuli such as piercing pain from a sharp object, heat from an open flame, or contact with corrosive chemicals are first detected by sensory receptors, called nociceptors, located on nerve endings. Nociceptors express ion channels that convert noxious stimuli into electrical signals. When these signals reach the brain via sensory neurons, they are perceived as pain.
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Local Anesthetics: Adverse Effects01:12

Local Anesthetics: Adverse Effects

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While local anesthetics are generally safe and well-tolerated, they can occasionally cause adverse effects that vary in severity. Local anesthetics can induce toxicity at two distinct levels. They can either produce local effects through direct contact with the neural elements or be absorbed into the bloodstream from the injection site, leading to systemic effects.
Once absorbed into the systemic circulation, local anesthetics can affect the organs that depend on the functioning of sodium...
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Updated: May 28, 2025

Assessment of Morphine-induced Hyperalgesia and Analgesic Tolerance in Mice Using Thermal and Mechanical Nociceptive Modalities
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Relationship of opioid tolerance to patient and wound factors, and wound micro-environment in patients with open

Jaewon Bae1, Amy Campbell2, Maria Hein1

  • 1University of Iowa, College of Nursing, US.

Journal of Wound Care
|February 10, 2025
PubMed
Summary

Opioid tolerance in patients with open wounds is linked to younger age, higher depression, and lower bacterial richness. These factors are key predictors of opioid tolerance in wound care settings.

Keywords:
injuriesmicrobiomeopioid toleranceopioid-related disorderspainwoundwound carewound dressingwound healing

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Area of Science:

  • Wound Care
  • Pain Management
  • Pharmacology

Background:

  • Opioid tolerance is a diagnostic criterion for opioid use disorder, a significant public health issue.
  • Opioid administration is common for patients with open wounds, yet opioid tolerance in this population remains understudied.
  • Understanding opioid tolerance in wound care is crucial for effective pain management and treatment strategies.

Purpose of the Study:

  • To investigate patient and wound characteristics associated with opioid tolerance in individuals with acute open wounds.
  • To compare the wound microbiome and inflammatory mediators between opioid-tolerant and opioid-naïve patients.
  • To identify key factors predicting opioid tolerance in the context of wound healing.

Main Methods:

  • A cross-sectional study design was employed, enrolling patients with acute open wounds.
  • Data collection included patient demographics, wound status, microbiome analysis, and inflammatory mediator assessment.
  • A one-time study dressing change was utilized for data acquisition prior to and during the procedure.

Main Results:

  • Opioid-tolerant participants (n=385) were younger, reported higher depression, anxiety, and pain catastrophizing.
  • Higher resting wound pain and a greater number of short-duration wounds (<30 days) were observed in opioid-tolerant individuals.
  • Wounds in opioid-tolerant patients exhibited lower bacterial richness compared to opioid-naïve individuals.

Conclusions:

  • This study offers the initial exploration of opioid tolerance within the context of open wounds.
  • Resting wound pain, age, bacterial richness, and depression emerged as significant predictors of opioid tolerance.
  • Findings provide a foundation for future hypothesis-driven research on opioid tolerance in wound management.