Wounds of War: New treatment eases war injury pain

By Randy Griffith Improvised explosive devices or IEDs in Iraq are causing an alarming loss of limbs and some of the most painful injuries known to medicine.
But a pioneering medical method developed two years ago at the John P. Murtha Neuroscience and Pain Institute here is helping wounded soldiers better cope with their suffering than in previous wars.
The technique uses an electric needle to pinpoint the nerves emitting pain from a badly mangled arm or leg, then blocks the pain by injecting a non-addictive anesthesia into the nerve center.
Dr. William Fritz, chief of anesthesiology at Memorial Medical Center, said the medicine also deadens the nerves that tell muscles to move, making it easier for surgeons in combat hospitals to repair or amputate a limb without the risks of a general anesthesia.
The technique is based on the medical theory that when an injury occurs, the brain memorizes the impulses from the wound and sends constant pain signals through the nerves - even after the wound heals. Blocking the nerve passageway stops the pain signals to the brain.
In past wars, the military routinely treated serious injuries with morphine, an addictive narcotic that prevents an injured person from feeling pain but does not stop the nerve system from emitting pain signals.
Furthermore, some soldiers experience nausea and vomit when injected with morphine. This reaction can limit the dosage given to a soldier transported from the battlefield, causing much of the pain to continue.
Doctors trained to use the nerve-blocker approach said it reduces pain to almost zero - with no side effects.
“It has changed the Army’s pain control for soldiers transported out of Iraq,” said Fritz.
Financed with a $1.3 million federal grant to the Murtha Institute, Fritz said, the technique was first used experimentally in Iraq, but has now become standard treatment for the wounds of war.
It is also used on civilian trauma patients at Memorial Medical Center, which is affiliated with the institute, and a few other hospitals, said Fritz.
“When we get a new generation of people (medical personnel) who are trained in the technique, it will be available in more (civilian) areas,” he said.
Military doctors said the nerve-blocker method is especially important in Iraq because the amputation rate is double that of previous wars. Many soldiers have suffered from the pain associated with losing arms or legs to IEDs.

Randy Griffith is a health-beat reporter for The Tribune-Democrat in Johnstown, Pa.