STABILIZATION OF INJURED PERSONNEL IN THE THEATRE OF WAR ENCOMPASSES THREE BROAD ASPECTS: 1) IMMOBILIZATION OF INJURED BODY PARTS; 2) RESTORATION OF AN ADEQUATE CIRCULATION WITH IV FLUIDS; 3) CONTROLLABLE ANAGESIA UNDER FIELD CONDITIONS.

STABILIZATION OF INJURED PERSONNEL IN THE THEATRE OF WAR ENCOMPASSES THREE BROAD ASPECTS: 1) IMMOBILIZATION OF INJURED BODY PARTS; 2) RESTORATION OF AN ADEQUATE CIRCULATION WITH IV FLUIDS; 3) CONTROLLABLE ANAGESIA UNDER FIELD CONDITIONS. THIS PROPOSAL ADDRESSES THE LAST ISSUE IN TERMS OF PATIENT-CONTROLLED, IONTOPHORETIC DELIVERY OF NARCOTIC AGENTS ON THE BATTLEFIELD. IONTOPHORESIS UTILIZED FOR DRUG DELIVERY HAS A VENERABLE HISTORY YET TO THIS DAY, ITS APPLICATION IS LIMITED TO SHORT PROCEDURES OF 15-30 MINUTES. THE MAJOR IMPEDIMENT TO TREATMENTS LASTING OF THE ORDER OF 6-12 HOURS HAS BEEN THE FORMATION OF ELECTROLYTIC PRODUCTS (H+ IN THE POSITIVE ELECTROD AND OHIN THE NEGATIVE ELECTRODE), WHICH RAPIDLY LOWER THE EFFICIENCY OF DRUG TRANSPORT. THIS PROBLEM HAS BEEN ADDRESSED BY OUR GROUP OVER THE PAST THREE YEARS USING MORPHINE AS THE MODEL DRUG. OUR CLINICAL STUDIES HAVE ACHIEVED A DELIVERY OF 5-6 MG FOR OVER TWO HOURS. THE GOALS IN PHSE I OF THIS PROPOSAL ARE: 1) TO PROLONG FURTHER THE DELIVERY TIME OF MORPHINE FROM A SINGLE ELECTRODE-RECEPTACLE; 2) TO INVESTIGATE THE RATE OF SYSTEMIC UPTAKE OF MORPHINE IN PIGS EXSANGUINATED BY 20% AND THEN 30% OF TOTAL BLOOD VOLUMES, EACH ANIMAL ACTING AS ITS OWN CONTROL; AND 3) TO CONSTRUCT A PROTOTYPE, PATIENTCONTROLLED IONTOPHORETIC DRUG DELIVERY UNIT FOR USE IN FIELD CONDITIONS: AN ADHESIVE PATCH CONTAINING MORPHINE, BATTERY SUPPLY AND CURRENT CONTROL. IN PHASE II THIS DEVICE WILL BE REFINED AND INTEGRATED INTO ONE UNIT, PRODUCED IN MUCH LARGER NUMBERS FOR USE IN CLINICAL TRIALS AND THE MORPHINE QUANTITY WILL BE IN GEL, PASTE OR GUM FORM, PRIMARILY TO PREVENT LEAKAGE OF CONTENTS BEFORE, DURING OR AFTER CLINICAL APPLICATION.