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Hemodynamic effects of morphine and nalbuphine in acute myocardial infarction
Author(s) -
Lee Garrett,
Low Reginald I,
Amsterdam Ezra A,
Demaria Anthony N,
Huber Paula W,
Mason Dean T
Publication year - 1981
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1038/clpt.1981.80
Subject(s) - nalbuphine , medicine , cardiac index , vascular resistance , pulmonary wedge pressure , anesthesia , heart rate , hemodynamics , myocardial infarction , blood pressure , cardiac output , cardiology , stroke volume , mean arterial pressure , morphine , opioid , receptor
Hemodynamic effects of morphine and the new narcotic analgesic, nalbuphine, were compared in a randomized, double‐blind study in 15 patients with acute myocardial infarction (11 men and four women, average age 56.2 yr) and normal group mean hemodynamic function. During a 1‐hr evaluation the hemodynamic effects were small but there were changes in several parameters. Morphine reduced heart rate (78 to 72 bpm, p < 0.01) and diastolic and mean arterial pressures (69 to 64 mm Hg, p < 0.05; and 91 to 84 mm Hg, p < 0.05); nalbuphine was associated with a decrease in heart rate (82 to 72 bpm, p < 0.01), decrease in cardiac index, which remained within the normal range (3.16 to 2.75 l/min/m 2 , p < 0.01), and an increase in systemic vascular resistance (1,204 to 1,461 dynes · sec · cm −5 , p < 0.05). Neither drug altered systolic arterial pressure, pulmonary artery pressure, pulmonary capillary wedge pressure, stroke index, stroke work index, or pulmonary vascular resistance. Echocardiographic assessment revealed diminution of left ventricular mean velocity of circumferential fiber shortening after nalbuphine (1.26 to 1.08 circlsec, p < 0.05). Both drugs induced small reductions in respiratory rate and arterial pH and increases in . There were no changes in Because of the absence of clinically important deleterious effects on cardiac pump function, nalbuphine merits further investigation as an analgesic in acute myocardial infarction. Clinical Pharmacology and Therapeutics (1981) 29, 576–581; doi: 10.1038/clpt.1981.80