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KMID : 0381219880200020188
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Journal of RIMSK
1988 Volume.20 No. 2 p.188 ~ p.201
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Clinical Investigations on the Cardiovascular Effects of Morphine, Meperidine, Tramadol and Pentazocine
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Jin, Hong Yong
Hwang, Se Yong/Cho, Heung Sang
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Abstract
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To investigate the cardiovascular effects of commonly used four analgesics such as morphine, meperidine, tramadol and pentazocine we, the authors, divided forty patients in ASA class 1 who were scheduled for the elective surgery into four groups such as morphine, meperidine, tramadol and pentazocine group. Each groupconsisted of ten patients. After intravenous injection of clinically equianalgetic doses of analgesics(morphine 10mg, meperidine 50mg, tramadol 50mg and pentazocine 30mg) to each group without pre medication. We measured sBP(systolic BP), dBP(diastolic BP), MAP(mean arterial pressure), HR(heart rate), RPP(rate-pressure product), TTI(tension-time index) and STI(systolic time intervals) values(QS2,LVET, PEP, PEP/LVET, 1/PEP2 and S2Q/QS2) in pre-injection state(control value), and every two minutes for 15 minutes after injection in each group.
The results were as follows:
1) Compared with the control value, there were no significant changes in sBP, dBP and MAP in all groups. In the morphine group HR was significantly increased at one minute after injection(p<0.05), but 3 minutes later it became normal. Other three groups had no significant changes in HR.
2) Compared with the control value, there were no significant changes in RPP and TTI in all groups.
3) All STI values had no significant changes in all groups except the pentazocine group. In the pentazocine group significantly shortened PEPC, decreased PEP/LVET and increased 1/PEPC2 appeared from eleven minutes after injection.(p<0.05)
According to above results morphine, meperidine and tramadol can be used safely within the clinically therapeutic doses without the significant cardiovascular unwanted effects, but it will be better to avoid pentazocine especially in the patients of the ischemic heart disease owing to increase in pre load and after load of the heart.
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