[Effect of long-term epidural analgesia and nitroglycerin infusion on formation of necrosis zone and clinical course of myocardial infarction].
OBJECTIVE
To study effects of long-term morphine-clofelin epidural analgesia and infusion of nitroglycerin on formation of the necrosis focus and the clinical course of acute myocardial infarction (MI).


METHODS
Ninety patients were examined within the first 12 hours of anterior macrofocal MI. Forty six patients of the study group received long-term morphine-clofelin epidural analgesia and nitroglycerine infusion within the first 24 hours of the disease. Forty-four control patients were anesthetized conventionally with intravenous morphine. Development of MI was assessed with electrocardiotopography and dynamic examination of MV CK in the blood serum.


RESULTS
The degree and area of the myocardial lesion were initially similar in the study and control groups. These indices were less in dynamics in the study group. On MI day 5 and 10 myocardial necrosis zone significantly diminished in the study group.


CONCLUSIONS
Long-term epidural analgesia and nitroglycerin infusion provide effective analgesia, localizes the ischemic and necrotic focus, have a good effect on hemodynamics and improve a MI clinical course.
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Tumak
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Dzizinskiĭ
D015360:Analgesia, Epidural; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000627:therapeutic use; D016022:Case-Control Studies; D003000:Clonidine / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000627:therapeutic use; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000473:pathology; D009336:Necrosis; D005996:Nitroglycerin / Q000008:administration & dosage / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use*
D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D014665:Vasodilator Agents; D009020:Morphine; D005996:Nitroglycerin; D003000:Clonidine