ANALGETIC TREATMENT IN ACUTE MYOCARDIAL-INFARCTION - A CONTROLLED CLINICAL COMPARISON OF MORPHINE, NICOMORPHINE AND PETHIDINE

  • 1 January 1984
    • journal article
    • research article
    • Vol. 215  (4) , 349-354
Abstract
In a randomized double-blind study with flexible dosage, morphine, nicomorphine and pethidine were compared with regard to analgetic effect, dose requirements, dose intervals and adverse reactions. A total of 275 patients were included, and 28 patients were excluded due to adverse reactions (n = 16) and for practical reasons. Acute myocardial infarction (AMI) was diagnosed in about 60% of the patients, and about 30% had ischemic heart disease without AMI. All 3 analgesics provided equally efficient pain relief in relative doses of morphine 10, nicomorphine 10 and pethidine 75 mg/ml. Severe adverse reactions were few (allergy 3 cases, respiratory insufficiency 4, severe bradycardia 4), whereas nausea was recorded in 20-30%, vomiting in 5-15% and dizziness in 10-30% of the patients, with no difference between the 3 drugs. Significant blood pressure drop (> 30 mmHg) was seen in 3-8% of the patients, with no significant differences between the drugs.