The article deals with pain relief in patients with combined pain syn drome on the background of ACS and Q myocardial infarction. The effectiveness of nalbuphine administration for noncoronary, muscu loarticular and radicular pain relief with its mixture with angina pain are analyzed. The effectiveness and necessity of the nalbuphine use in analgesia for acute and chronic somatogenic pain syndrome in patients with complicated and uncomplicated course of STEMI are reaveled. It was shown that the inefficiency of the first injection nalbuphine already indicates a possible recurrent coronary event that requires a review and intensification of basic antianginal medication and imme diate transition to standard morphine analgesia. Authors proposed to apply nalbuphine as a safe and effective analgesic for the relief of acute and chronic somatogenetic pain experienced by patients with ACS and Q myocardial infarction along with anginal one.