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Analgesia in Myocardial Infarction

  • Practical Therapeutics
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Summary

The treatment of pain in the acute phase of a suspected acute myocardial infarction is often insufficient and has remained unchanged during recent years. The introduction of substances with a potential to limit the infarct size, such as thrombolysis and β-blockade, have, however, decreased the requirement for narcotic analgesics (which are still the drugs of choice in many hospitals). Knowledge is still lacking regarding the duration of pain relief, the time between drug administration and pain relief, and optimal doses for various analgesics. Future research should aim at the development of drugs with a more rapid onset of action, less side effects and more complete analgesia.

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References

  • Alderman EL. Analgesics in the acute phase of myocardial infarction. Journal of the American Medical Association 229: 1646–1648, 1974

    Article  PubMed  CAS  Google Scholar 

  • Alderman EL, Barry WH, Graham AF, Harrison DC. Hemodynamic effects of morphine and pentazocine differ in cardiac patients. New England Journal of Medicine 287: 623–627, 1972

    Article  PubMed  CAS  Google Scholar 

  • Anderson JL, Marshall HW, Askins JC, et al. A randomized trial of intravenous and intracoronary streptokinase in patients with acute myocardial infarction. Circulation 70: 606–618, 1984

    Article  PubMed  CAS  Google Scholar 

  • Bondestam E, Hovgren K, Gaston Johansson F, et al. Pain assessment by patient and nurse in the early phase of acute myocardial infarction. Journal of Advanced Nursing 12: 677–682, 1987

    Article  PubMed  CAS  Google Scholar 

  • Bressan MA, Costantini M, Klersy C, et al. Analgesic treatment in acute myocardial infarction: a comparison between indoprofen and morphine by a double-blind randomised pilot study. International Journal of Clinical Pharmacology, Therapy and Toxicology 23: 668–672, 1985

    CAS  Google Scholar 

  • Davidsen O, Lindeneg O, Walsh M. Analgesic treatment with levomepromazine in acute myocardial infarction. Acta Medica Scandinavica 205: 191–194, 1979

    Article  PubMed  CAS  Google Scholar 

  • GISSI (Gruppo Italiano per lo Studio della Streptochi-nasi nell’Infarto Miocardico). Long-term effects of intravenous thrombolysis in acute myocardial infarction: final report of the GISSI study. Lancet 2: 871–874, 1987

    Google Scholar 

  • Hayes MJ, Fraser AR, Hampton JR. Randomised trial comparing buprenorphine and diamorphine for chest pain in suspected acute myocardial infarction. British Medical Journal 2: 300–302, 1979

    Article  PubMed  CAS  Google Scholar 

  • Herlitz J, Elmfeldt D, Hjalmarson Å, Holmberg S, Málek I, et al. Effect of metoprolol on indirect signs of the size and severity of acute myocardial infarction. American Journal of Cardiology 51: 1282–1288, 1983

    Article  PubMed  CAS  Google Scholar 

  • Herlitz J, Hjalmarson Å, Holmberg S, et al. Effect of metoprolol on chest pain in acute myocardial infarction. British Heart Journal 51: 438–444, 1984a

    Article  PubMed  CAS  Google Scholar 

  • Herlitz J, Pennert K, Wedel H, et al. Tolerance. American Journal of Cardiology 53(13): 46D-50D, 1984b

    Google Scholar 

  • Herlitz J, Richter A, Hjalmarson Å, et al. Variability of chest pain in suspected acute myocardial infarction according to subjective assessment and requirement of narcotic analgesics. International Journal of Cardiology 13: 9–22, 1986

    Article  PubMed  CAS  Google Scholar 

  • International Collaborative Study Group. Reduction of infarct size with the early use of timolol in acute myocardial infarction. New England Journal of Medicine 310: 9–15, 1984

    Article  Google Scholar 

  • ISIS-1 Collaborative Group. A randomised trial of intravenous atenolol among 16,027 cases of suspected acute myocardial infarction. Lancet 2: 57–66, 1986

    Google Scholar 

  • Kaplan K, Davidsson R, Parker M, et al. Intravenous nitroglycerin for the treatment of angina at rest unresponsive to standard nitrate therapy. American Journal of Cardiology 51: 694–698, 1983

    Article  PubMed  CAS  Google Scholar 

  • Kerr F, Donald KW. Analgesia in myocardial infarction. British Heart Journal 36: 117–121, 1974

    Article  PubMed  CAS  Google Scholar 

  • Laffel GL, Braunwald E. Thrombolytic therapy. A new strategy for the treatment of acute myocardial infarction. First of two parts. New England Journal of Medicine 311: 710–717, 1984

    Article  PubMed  CAS  Google Scholar 

  • Lasagna L, Beecher HK. The optimal dose of morphine. Journal of the American Medical Association 156: 230–234, 1954

    Article  PubMed  CAS  Google Scholar 

  • Lee G, DeMaria AN, Amsterdam EA, et al. Comparative effects of morphine, meperidine and pentazocine on cardiocirculatory dynamics in patients with acute myocardial infarction. American Journal of Medicine 60: 949–955, 1976

    Article  PubMed  CAS  Google Scholar 

  • Lis Y, Bennett D, Lambert G, Robson D. A preliminary double-blind study of intravenous nitroglycerin in acute myocardial infarction. Intensive Care Medicine 10: 179–184, 1984

    Article  PubMed  CAS  Google Scholar 

  • Mannheimer C, Carlsson CA, Emanuelsson H, et al. The effects of transcutaneous electrical nerve stimulation in patients with severe angina pectoris. Circulation 71: 308–316, 1985

    Article  PubMed  CAS  Google Scholar 

  • Maroko PR, Hillis LD, Muller JE, Tavazzi L, Heyndrickx GR, et al. Favorable effects of hyaluronidase on electrocardiographic evidence of necrosis in patients with acute myocardial infarction. New England Journal of Medicine 296: 898–903, 1977

    Article  PubMed  CAS  Google Scholar 

  • MIAMI Trial Research Group. Metoprolol in acute myocardial infarction (MIAMI). A randomised placebo-controlled trial. European Heart Journal 6: 199–226, 1985a

    Google Scholar 

  • MIAMI Trial Research Group. Other clinical findings and tolerability. American Journal of Cardiology 56: 39G–46G, 1985b

    Article  Google Scholar 

  • Nielsen JR, Pedersen KE, Dahlström CG, et al. Analgetic treatment in acute myocardial infarction. A controlled clinical comparison of morphine, nicomorphine and pethidine. Acta Medica Scandinavica 215: 349–354, 1984

    Article  PubMed  CAS  Google Scholar 

  • Pasqualucci V. Advances in the management of cardiac pain. Advances in Pain Research and Therapy 7: 501–504, 1984

    Google Scholar 

  • Pasqualucci V, Moricca G, Solinas P. Intrathecal morphine for the control of the pain of myocardial infarction. Anaesthesia 36: 68–69, 1981

    Article  PubMed  CAS  Google Scholar 

  • Richterova A, Herlitz J, Holmberg S, et al. Effects on chest pain. American Journal of Cardiology 53(13): 32D-36D, 1984

    Google Scholar 

  • Scott ME, Orr R. Effects of diamorphine, methadone, morphine, and pentazocine in patients with suspected acute myocardial infarction. Lancet 1: 1065–1067, 1969

    Article  PubMed  CAS  Google Scholar 

  • Selwyn AP, Fox KM, Welman E, Jonathan A, Shillingford JP. Electrocardiographic precordial mapping in anterior myocardial infarction. The critical period for interventions as exemplified by methylprednisolone. Circulation 58: 892–897, 1978

    Article  PubMed  CAS  Google Scholar 

  • Semenkovich CF, Jaffe AS. Adverse effects due to morphine sulfate. Challenge to previous clinical doctrine. American Journal of Medicine 79: 325–330, 1985

    Article  PubMed  CAS  Google Scholar 

  • Thomas M, Malmcrona R, Fillmore S, Shillingford J. Haemodynamic effects of morphine in patients with acute myocardial infarction, British Heart Journal 27: 863–875, 1965

    Article  PubMed  CAS  Google Scholar 

  • Thompson PL, Lown B, Nitrous oxide as an analgesic in acute myocardial infarction. Journal of the American Medical Association 325: 924–927, 1976

    Article  Google Scholar 

  • Todres D. The role of morphine in acute myocardial infarction. American Heart Journal 81: 566–570, 1971

    Article  PubMed  CAS  Google Scholar 

  • Van der Laarse A, Vermeer F, Hermens WT, Willems GM, de Neef K, et al. Effects of early intracoronary streptokinase on infarct size estimated from cumulative enzyme release and on enzyme release rate: a randomized trial of 533 patients with acute myocardial infarction. American Heart Journal 112: 672–681, 1986

    Article  PubMed  Google Scholar 

  • Waagstein F, Hjalmarson Å. Double-blind study of the effect of cardioselective beta-blockade on chest pain in acute myocardial infarction. Acta Medica Scandinavica 587 (Suppl.): 201–208, 1975

    Google Scholar 

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  1. Department of Medicine I, Sahlgrenska Hospital, University of Göteborg, S-413 45, Göteborg, Sweden

    Johan Herlitz

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  1. Johan Herlitz
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Herlitz, J. Analgesia in Myocardial Infarction. Drugs 37, 939–944 (1989). https://doi.org/10.2165/00003495-198937060-00007

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  • DOI: https://doi.org/10.2165/00003495-198937060-00007

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