Abstract
Pain and fear may predispose to cardiac arrest in myocardial infarction, perhaps by increasing the risk of ventricular fibrillation by promoting the secretion of catecholamines. A regimen designed to reduce pain and fear was tried in fifty-nine patients in an intensive-care unit. The regimen consisted of maintaining the patient in a light sleep, by means of pethidine and promethazine, for 1-7 days, waking the patient thrice daily for feeding, washing, and physiotherapy. The patient was transferred to general wards 3-5 days after the end of the sleep regimen. The only death in the intensive-care unit was from gastrointestinal haemorrhage; arrhythmias did develop but in no case were they refractory. Eight patients (14%) died in hospital after they had left the unit.
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