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September 16, 1974

Analgesics in the Acute Phase of Myocardial Infarction

Author Affiliations

From the Cardiology Division, Stanford University School of Medicine, Stanford, Calif.

JAMA. 1974;229(12):1646-1648. doi:10.1001/jama.1974.03230500062035

THE pain of myocardial infarction may be severe and persistent, but generally disappears once effective analgesic therapy is given. The pain itself and the associated stresses of hospitalization, physician examination, and the fear of illness and potential death tend to provoke a prominent anxiety state. These factors promote hyperventilation and restlessness, and thus greater demands for oxygen, all of which impose greater stress on the damaged heart. Morphine sulfate has generally been the drug of choice for pain relief under these circumstances, but other agents such as meperidine hydrochloride and pentazocine have been suggested. In most respects, meperidine may be considered similar to morphine. Although it had been thought that meperidine is spasmolytic and is less prone to produce respiratory depression, nausea, and vomiting, this has not been borne out by controlled studies of equipotential doses. It is important in the selection of an analgesic agent that its respiratory and