An Evidence-Based Review of Pain Management in Acute Myocardial Infarction

Since the turn of the twentieth century, morphine, an opioid analgesic, has played an integral role in the management of pain in myocardial infarction (MI). This is attributed to morphine’s effect on reducing blood pressure, slowing heart rate, and relieving anxiety, which may decrease myocardial oxygen demand, added to the fact that morphine has been studied extensively in pain management in many settings. For this morphine kept considered amongst the first line therapies and most effective for acute pain management in MI patients according to many guidelines. However, observational data suggest that morphine administration during acute myocardial infarction (AMI) may have negative consequences, while this practice also lacks supporting rigorous evidence or studies designed to assess the effect of morphine administration. Added to this recent evidence uncovered that morphine may impede gastrointestinal absorption of oral antiplatelet drugs important in reducing mortality