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The Analgesic Effect of Oxygen in Suspected Acute Myocardial Infarction : A Substudy of the DETO2X-AMI Trial

, ; Sparv, David LU ; Hofmann, Robin; Gunnarsson, Annika; James, Stefan; Hedberg, Camilla; Lauermann, Jörg; Torild, Petronella; Omerovic, Elmir and Bergström, Kristina, et al. (2018) In JACC: Cardiovascular Interventions 11(16). p.1590-1597
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 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... (More)

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.

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published
subject
keywords
analgesic effect, oxygen, ST-segment elevation myocardial infarction
in
JACC: Cardiovascular Interventions
volume
11
issue
16
pages
8 pages
publisher
Elsevier
external identifiers
  • scopus:85051257129
ISSN
1936-8798
DOI
10.1016/j.jcin.2018.04.043
language
English
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yes
id
e07f359f-d7d3-4724-8ab8-b99e8e2b4feb
date added to LUP
2018-09-07 12:36:36
date last changed
2019-03-19 03:59:01
@article{e07f359f-d7d3-4724-8ab8-b99e8e2b4feb,
  abstract     = {<p>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.</p>},
  author       = {,  and Sparv, David and Hofmann, Robin and Gunnarsson, Annika and James, Stefan and Hedberg, Camilla and Lauermann, Jörg and Torild, Petronella and Omerovic, Elmir and Bergström, Kristina and Haugen, Espen and Bergström, Camilla and Linder, Rikard and Borg, Pia and Haaga, Urban and Olsson, Anneli and Böving, Elin and Östlund, Ollie and Rylance, Rebecca and Witt, Nils and Erlinge, David},
  issn         = {1936-8798},
  keyword      = {analgesic effect,oxygen,ST-segment elevation myocardial infarction},
  language     = {eng},
  month        = {08},
  number       = {16},
  pages        = {1590--1597},
  publisher    = {Elsevier},
  series       = {JACC: Cardiovascular Interventions},
  title        = {The Analgesic Effect of Oxygen in Suspected Acute Myocardial Infarction : A Substudy of the DETO2X-AMI Trial},
  url          = {http://dx.doi.org/10.1016/j.jcin.2018.04.043},
  volume       = {11},
  year         = {2018},
}