Control of variceal bleed with metoclopramide.
Artigo
em Inglês
| IMSEAR
| ID: sea-63712
ABSTRACT
The efficacy of parenteral metoclopramide in the control of active variceal bleeding was assessed in a prospective, randomized, double blind, placebo controlled trial. Patients with portal hypertension due to different etiologies (cirrhosis, non cirrhotic portal fibrosis and extrahepatic portal venous obstruction) with endoscopically documented active variceal bleeding entered the study. Forty nine consecutive patients were randomized after pre-entry stratification for Child's scores. Intravenous metoclopramide (20 mg) or 2 ml dextrose was administered in all patients while the first endoscopy documented an active variceal bleeding. All patients were subjected to a second endoscopy 15 minutes later to determine control of bleeding. Rebleeding rate, transfusion requirement, adverse effects and mortality were analysed. Twenty of the 25 patients treated with metoclopramide stopped bleeding compared to 5 of 24 in the control group (p less than 0.05). Rebleeding occurred in 4 of 20 in the metoclopramide group and 4 of 5 in the control group within 72 hours (p less than 0.05). The number of patients requiring blood transfusion (10 vs 16) and the transfusion requirement (1.8 +/- 2.2 vs 3.6 +/- 2.1 units) were significantly lower (p less than 0.01) in the metoclopramide group than in the control group. Mortality was similar and there were no complications due to therapy. We conclude that intravenous metoclopramide is a safe and effective agent for the control of acute esophageal variceal bleeding.
Texto completo:
DisponíveL
Índice:
IMSEAR (Sudeste Asiático)
Assunto principal:
Transfusão de Sangue
/
Feminino
/
Humanos
/
Masculino
/
Varizes Esofágicas e Gástricas
/
Escleroterapia
/
Método Duplo-Cego
/
Estudos Prospectivos
/
Adolescente
/
Adulto
Tipo de estudo:
Ensaio Clínico Controlado
/
Estudo observacional
Idioma:
Inglês
Ano de publicação:
1991
Tipo de documento:
Artigo
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