Наркотики при безболевых формах ОИМ
 

Показано ли введение наркотических анальгетиков при безболевом ОИМ?
И в частности, при нижнем инфаркте с кардиогенным шоком (АД до 50/30), гипергликемией (30 ммоль/л), угнетением сознания (оглушение) и дыхательной недостаточностью?
Желательно, если есть указания на литературные источники.

Current American College of Cardiology/American Heart Association guidelines for the management of patients with STEMI [7] state that in the absence of a history of hypersensitivity, IV morphine sulfate is the preferred drug for pain relief.

European Society of Cardiology (ESC) guidelines [35] for the management of STEMI patients recommend intravenous morphine for relief of ischemic chest pain.

нет боли - нет и наркотикам

Keeping the side effects of morphine in mind, some previous studies showed that its use resulted in increased inhospital mortality, such as Meine et al. [43]. However, this study was not a randomized controlled one; furthermore, morphine was given to higher-risk patients. Another study [44] showed that STEMI patients who did not use morphine had a significant improvement in the ECG-based primary endpoint (potentially reflecting better myocardial reperfusion).

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