Comparative effects of morphine, meperidine and pentazocine on cardiocirculatory dynamics in patients with acute myocardial infarction.
The cardiocirculatory effects of the commonly used parenteral analgesics, morphine sulfate 15 mg, meperidine hydrochloride 100 mg and pentazocine 60 mg, each administered intravenously, were compared in 12 patients with acute myocardial infarction during cardiac catheterization and by echocardiogram. No untoward hemodynamic effects occurred following the administration of morphine or meperidine. In contrast, pentazocine produced significant (p less than 0.01 to less than 0.05) increases in systemic and pulmonary arterial pressures, left ventricular filling pressure, systemic vascular resistance, and systolic and diastolic dimensions; and decreases in left ventricular ejection fraction and mean velocity of circumferential fiber shortening. These deleterious actions of pentazocine appeared due to peripheral vasoconstriction and negative inotropic properties. Further, pentazocine-induced increases in left ventricular preload and afterload increased myocardial oxygen demands. Since this study demonstrates that pentazocine is hazardous in myocardial infarction, morphine and meperidine are the preferred analgesics in this condition.
D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000187:drug effects; D002302:Cardiac Output / Q000187:drug effects; D004562:Electrocardiography; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D008297:Male; D008614:Meperidine / Q000494:pharmacology* / Q000627:therapeutic use; D008875:Middle Aged; D009020:Morphine / Q000494:pharmacology* / Q000627:therapeutic use; D009203:Myocardial Infarction / Q000188:drug therapy*; D010423:Pentazocine / Q000494:pharmacology* / Q000627:therapeutic use; D012119:Respiration / Q000187:drug effects; D014655:Vascular Resistance / Q000187:drug effects
D009020:Morphine; D008614:Meperidine; D010423:Pentazocine