P. Burduk et al., Comparison of fentanyl and droperidol mixture (neuroleptanalgesia II) withmorphine on clinical outcomes in unstable angina patients, CARDIO DRUG, 14(3), 2000, pp. 259-269
Citations number
76
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
The objective of the study was to compare the influence of a fentanyl and d
roperidol mixture (neuroleptanalgesia) with morphine on the in-hospital ins
tability, development of acute myocardial infarction (AMI), and mortality d
uring a 30-day and 12-month follow-up in unstable angina patients. The stud
y was performed in 112 unstable angina patients. In addition to standard th
erapy for unstable angina (aspirin, heparin, nitroglycerin, and oxygen), 53
patients (63.2 +/- 9.7 years; 32 males) were randomized to receive neurole
ptanalgesia (0.025 mg fentanyl and 1.25 mg droperidol in a volume of 1 mL)
and 59 patients (58.6 +/- 11.5 years; 41 males) to receive morphine. Neurol
eptanalgesia was started IV with 2 mL and could be followed by 1 mL every 4
hours. Morphine was started IV with 10 mg and could be followed by 5 mg ev
ery 4 hours up to angina resolution during 24 hours of hospitalization. Ano
ther 1 mL of neuroleptanalgesia or 5 mg of morphine could be administered o
n demand if angina lasted or reappeared earlier than the next scheduled dos
e. Odds ratios with 95% confidence intervals (95% CI) adjusted for the age,
sex, smoking, previous myocardial infarction, and hypertension were evalua
ted for all study outcomes. The odds ratios for clinical in-hospital instab
ility (5.93, 95% CI: 2.49-14.15; P = 0.0001), 12-month AMI development (3.5
7, 95% CI: 1.51-8.45; P = 0.0038), and 12-month mortality (6.00, 95% CI: 1.
63-22.09; P = 0.0070) were significantly increased in the neuroleptanalgesi
a group compared with the patients on morphine. It is concluded that neurol
eptanalgesia negatively influences disease course, AMI development, and tot
al mortality in unstable angina patients.