Abstract
Objective. To compare variants of sedation for patients presenting with acute coronary syndrome after percutaneous revascularization.
Methods. The randomized trial has been conducted (envelopes method) regarding the condition of 116 sequentially admitted patients with acute
myocardial infarction of Killip I–II classification after successful percutaneous revascularization of the symptom-related artery. Standard sedation
was administered for 47 patients (i.e. ketanov intramuscular, relium intramuscular, phenobarbital p/os), for 69 – in combination with anxiolytics
(i.e. afobazole, atarax) and amitriptyline. Patients who received narcotic analgesics were excluded. Scoring questionnaire of patients was conducted
24 hours later according three parameters: unpleasant sensation; one's own condition; comfort stay in hospital and postoperative period related
stress. The presence of postoperative anxiety/depression was assessed. The level of sedation was determined by summarizing of scores i.e. 4–6 as
satisfactory, 7–11 as unsatisfactory, 12–16 as insufficient.
Results. At the intergroup comparison as for subjective perception (2.35±0.2 vs. 1.55±0.25, p = 0.02), as for one's own condition (2.75±0.15) vs.
1.3±0.1; p = 0.015), comfort stay (2.1±0.2 vs. 1.6±0.15; p = 0.033) the best results have been received with increasing of sedation by anxiolytics.
While objectively assessing presence of clinically significant anxiety (12.8 vs. 4.3 %, p =0.011) and stress related condition (max 3.0 vs. 2.8) the best
result was reported under the usual scheme in combination with amitriptyline. In the whole the satisfactory level of sedation in the investigated
group was more frequent in 64.3 % of patients vs. 47.5 % under the standard scheme (p = 0.0199).
Conclusion. Standard sedation in patients with acute coronary syndrome after percutaneous revascularization should be increased by orally intake
of antianxiety agents, i.e. anxiolytics and antidepressants.
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About the authors
Plotnikov Georgiy Pavlovich, Doctor of Medical Sciences, leading scientific associate;
Shukevich Dmitriy Leonidovich, Doctor of Medical Sciences, chief of laboratory;
Vasil'ev Sergey Viktorovich, chief of department;
Grigor'ev Evgeniy Valer'evich, Doctor of Medical Sciences, director assistant on science;
Barbarash Leonid Semenovich, academician, member of Russian Academy of Medical Sciences, director of Kemerovo Cardiologic Dispensary
