Effect of long-term epidural analgesia and nitroglycerin infusion on formation of necrosiszone and clinical course of myocardial infarction

Abstract

Aim. 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). Material and 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 anes- thetized conventionally with intravenous morphine. Development of MI was assessed with electrocardi- otopography 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. Conclusion. Long-term epidural analgesia and nitroglycerin infusion provide effective analgesia, lo- calizes the ischemic and necrotic focus, have a good effect on hemodynamics and improve a MI clini- cal course.

Keywords

• myocardial infarction
• epidural analgesia
• morphine
• clofelin
• nitroglycerin