Aspects on the intensity and the relief of pain in the prehospital phase of acute coronary syndrome: experiences from a randomized clinical trial

Coronary Artery Disease
Crister ZedighJ Herlitz

Abstract

The primary aim of this study was to evaluate the pain relief and tolerability of two pain-relieving strategies in the prehospital phase of presumed acute coronary syndrome (ACS), and the secondary aim was to assess the relationship between the intensity and relief of pain and heart rate, blood pressure, and ST deviation. Patients with chest pain judged as caused by ACS were randomized (open) to either metoprolol 5 mg intravenously (i.v.) three times at 2-min intervals (n = 84; metoprolol group) or morphine 5 mg i.v. followed by metoprolol 5 mg three times i.v (n = 80; morphine group). Pain was assessed on a 10-grade scale before randomization and 10, 20, and 30 min thereafter. The mean pain score decreased from 6.5 at randomization to 2.8 30 min later, with no significant difference between groups. The percentages with complete pain relief (pain score < or = 1) after 10, 20, and 30 min were 11, 16, and 21%, respectively, with no difference between groups. Hypotension was less frequent in the metoprolol group compared with the morphine group (0 vs. 6.3%; P=0.03), as was nausea/vomiting (7.2 vs. 24.0%; P=0.004). At randomization intensity of pain was associated with degree of ST elevation (P=0.009). The degree of pain relief ove...Continue Reading

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Citations

Nov 28, 2013·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Marianne Gausche-HillEddy S Lang
Nov 3, 2010·International Journal of Cardiology·Johan HerlitzBirgitta Wireklint-Sundström
Jun 23, 2012·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Edith Nutescu
Feb 9, 2019·Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine·Kristian D FriesgaardLone Nikolajsen
May 14, 2020·Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine·Sandrine CharpentierUNKNOWN SCADOL II investigators

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