David Sparv1, Robin Hofmann2, Annika Gunnarsson3, Stefan James4, Camilla Hedberg5, Jörg Lauermann5, Petronella Torild6, Elmir Omerovic6, Kristina Bergström7, Espen Haugen8, Camilla Bergström9, Rikard Linder9, Pia Borg10, Urban Haaga11, Anneli Olsson12, Elin Böving13, Ollie Östlund14, Rebecca Rylance15, Nils Witt2, David Erlinge15. 1. Department of Cardiology, Clinical Sciences, Lund University, Lund, Sweden. Electronic address: David.Sparv@med.lu.se. 2. Department of Clinical Science and Education, Division of Cardiology, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden. 3. Department of Cardiology, Uppsala University Hospital, Uppsala, Sweden. 4. Department of Medical Sciences and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden. 5. Department of Internal Medicine, Division of Cardiology, Ryhov Hospital, Jönköping, Sweden. 6. Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden. 7. Department of Cardiology, Gävle Sjukhus, Gävle, Sweden. 8. Department of Cardiology, Sundsvall Regional Hospital, Sundsvall, Sweden. 9. Department of Cardiology, Danderyd University Hospital, Stockholm, Sweden. 10. Svensk PCI Värmland AB, Karlstad, Sweden. 11. Department of Cardiology, Central Hospital Karlstad, Karlstad, Sweden. 12. Department of Cardiology, Skane University Hospital, Lund, Sweden. 13. Department of Cardiology, Södersjukhuset, Stockholm, Sweden. 14. Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden. 15. Department of Cardiology, Clinical Sciences, Lund University, Lund, Sweden.
Abstract
OBJECTIVES: In this substudy of the DETO2X-AMI (An Efficacy and Outcome Study of Supplemental Oxygen Treatment in Patients With Suspected Myocardial Infarction) trial, the authors aimed to assess the analgesic effect of moderate-flow oxygen supplementation in patients with suspected acute myocardial infarction (AMI) treated withpercutaneous coronary intervention (PCI) and to study the effect of oxygen supplementation on the use of opiates and sedatives during PCI. BACKGROUND: Routine oxygen in normoxemic patients with AMI does not provide clinical benefit. However, oxygen may relieve ischemic pain. METHODS: Patients were randomly allocated to oxygen or ambient air according to the main study protocol. After PCI, peak level of pain during PCI was measured by the Visual Analogue Scale. The total amount of opiates and sedatives was reported. RESULTS: A total of 622 patients were enrolled: 330 in the oxygen group and 292 in the ambient air group. There was no significant difference in peak level of pain (oxygen 4.0 [1.0 to 6.0] vs. air 3.0 [0.6 to 6.0]; p = 0.37), use of opiates (mg) (oxygen 0.0 [0.0 to 3.0] vs. air 0.0 [0.0 to 3.0]; p = 0.31), or use of sedatives between the groups (median [interquartile range]) (oxygen 2.5 [0.0 to 2.5] vs. air 2.5 [0.0 to 2.5]; p = 0.74). CONCLUSIONS: In the present study, the authors did not find any analgesic effect of routine oxygen as compared with ambient air, and no differences in the use of sedatives and opiates during PCI. Our results indicate that moderate-flow oxygen supplementation does not relieve pain in normoxemic patients with suspected AMI undergoing treatment withPCI and should thus not be used for this purpose.
RCT Entities:
OBJECTIVES: In this substudy of the DETO2X-AMI (An Efficacy and Outcome Study of Supplemental Oxygen Treatment in Patients With Suspected Myocardial Infarction) trial, the authors aimed to assess the analgesic effect of moderate-flow oxygen supplementation in patients with suspected acute myocardial infarction (AMI) treated with percutaneous coronary intervention (PCI) and to study the effect of oxygen supplementation on the use of opiates and sedatives during PCI. BACKGROUND: Routine oxygen in normoxemic patients with AMI does not provide clinical benefit. However, oxygen may relieve ischemic pain. METHODS:Patients were randomly allocated to oxygen or ambient air according to the main study protocol. After PCI, peak level of pain during PCI was measured by the Visual Analogue Scale. The total amount of opiates and sedatives was reported. RESULTS: A total of 622 patients were enrolled: 330 in the oxygen group and 292 in the ambient air group. There was no significant difference in peak level of pain (oxygen 4.0 [1.0 to 6.0] vs. air 3.0 [0.6 to 6.0]; p = 0.37), use of opiates (mg) (oxygen 0.0 [0.0 to 3.0] vs. air 0.0 [0.0 to 3.0]; p = 0.31), or use of sedatives between the groups (median [interquartile range]) (oxygen 2.5 [0.0 to 2.5] vs. air 2.5 [0.0 to 2.5]; p = 0.74). CONCLUSIONS: In the present study, the authors did not find any analgesic effect of routine oxygen as compared with ambient air, and no differences in the use of sedatives and opiates during PCI. Our results indicate that moderate-flow oxygen supplementation does not relieve pain in normoxemic patients with suspected AMI undergoing treatment with PCI and should thus not be used for this purpose.
Authors: Robin Hofmann; Tamrat Befekadu Abebe; Johan Herlitz; Stefan K James; David Erlinge; Troels Yndigegn; Joakim Alfredsson; Thomas Kellerth; Annica Ravn-Fischer; Sebastian Völz; Jörg Lauermann; Tomas Jernberg; Bertil Lindahl; Sophie Langenskiöld Journal: Front Cardiovasc Med Date: 2021-03-15
Authors: David Hohenschurz-Schmidt; Bethea A Kleykamp; Jerry Draper-Rodi; Jan Vollert; Jessica Chan; McKenzie Ferguson; Ewan McNicol; Jules Phalip; Scott R Evans; Dennis C Turk; Robert H Dworkin; Andrew S C Rice Journal: Pain Date: 2022-01-01 Impact factor: 6.961