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Title: Comparison of nalbuphine hydrochloride versus morphine sulfate for acute myocardial infarction with elevated pulmonary artery wedge pressure.
Author: Roth A, Keren G, Gluck A, Braun S, Laniado S.
Journal: Am J Cardiol; 1988 Sep 15; 62(9):551-5. PubMed ID: 3414546.
Abstract:
The hemodynamic and respiratory effects of intravenous nalbuphine hydrochloride and morphine sulfate were compared in a randomized fashion in 20 patients (age 65 +/- 11 years) with acute myocardial infarction and elevated pulmonary artery wedge pressure. Titration of the nalbuphine dose to lower pulmonary artery wedge pressure by greater than or equal to 25% resulted in a decrease of this parameter from 22 +/- 3 to 15 +/- 4 mm Hg, and was associated with a reduction in heart rate from 106 +/- 20 to 96 +/- 19 beats/min (p less than 0.05) and decreases in mean blood pressure (78 +/- 8 to 70 +/- 12 mm Hg, p less than 0.05) and mean pulmonary artery pressure (31 +/- 4 to 22 +/- 5 mm Hg, p less than 0.05), without any remarkable change seen in cardiac index (2.21 +/- 0.43 to 2.22 +/- 0.50 liter/min/m2, difference not significant), stroke volume index (22 +/- 7 to 23 +/- 4 ml/m2, difference not significant), stroke work index (17 +/- 7 to 18 +/- 7 g.m/m2), or systemic and pulmonary vascular resistances (1,675 +/- 333 to 1,513 +/- 508 and 191 +/- 78 to 170 +/- 109 dynes.s.cm-5 respectively, all differences not significant). Nalbuphine also significantly reduced respiratory rate (32 +/- 8 to 26 +/- 8 resp/min, p less than 0.05) and pH (7.45 +/- 0.04 to 7.41 +/- 0.03, p less than 0.05) and increased arterial PCO2 (32 +/- 6 to 35 +/- 6 mm Hg, p less than 0.05) without any major change in arterial PO2 (63 +/- 13 to 66 +/- 17 mm Hg, difference not significant).(ABSTRACT TRUNCATED AT 250 WORDS)

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