Pain management in ST-segment elevation myocardial infarction: an observational analysis

Abstract

Aim: ST-segment elevation myocardial infarction (STEMI) is one of the most severe forms of pain. However, the guidelines give quite a few places for pain control in STEMI and, do not offer strong recommendations on this issue. This study aimed to reveal which medications are given to STEMI patients for pain control until they arrive at the catheter laboratory, in which situations they are used, and the frequency of use. Material and Method: A total of 272 consecutive STEMI patients were prospectively collected. Medications were administered to the patients until they arrived at the angiography laboratory; vital signs, comorbidities, referral status, infarction types, the time between the onset of pain and the admission to the emergency department, and the door-balloon time were also noted. The patients’ pain characteristics and intensity were evaluated. Results: It was observed that 96.3% of the patients presented with chest pain. The pain of diabetic patients was severe according to the visual analog scale (VAS) score (p=0.023). It was witnessed that 9.92% of the patients were administered drugs for analgesic purposes. The most commonly administered medication was paracetamol. It was noticed that morphine was used frequently after paracetamol. Medication administration for analgesia was more common in referred patients (p=0.040). Conclusion: Physicians behave timidly in their clinical practice in pain control of STEMI and move away from the guideline. In terms of comfort and hemodynamic stabilization of the patients, it will be beneficial for the applications in the field to give more place to the treatments for pain control in the guidelines.