Document Detail


Optimal injection volume of epinephrine for endoscopic treatment of peptic ulcer bleeding.
MedLine Citation:
PMID:  16718798     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To define the optimal injection volume of epinephrine with high efficacy for hemostasis and low complication rate in patients with actively bleeding ulcers.
METHODS: This prospective, randomized, comparative trial was conducted in a medical center. A total of 228 patients with actively bleeding ulcers (spurting or oozing) were randomly assigned to three groups with 20, 30 and 40 mL endoscopic injections of an 1:10000 solution of epinephrine. The hemostatic effects and clinical outcomes were compared between the three groups.
RESULTS: There were no significant differences in all background variables between the three groups. Initial hemostasis was achieved in 97.4%, 98.7% and 100% of patients respectively in the 20, 30 and 40 mL epinephrine groups. There were no significant differences in the rate of initial hemostasis between the three groups. The rate of peptic ulcer perforation was significantly higher in the 40 mL epinephrine group than in the 20 and 30 mL epinephrine groups (P < 0.05). The rate of recurrent bleeding was significantly higher in the 20 mL epinephrine group (20.3%) than in the 30 (5.3%) and 40 mL (2.8%) epinephrine groups (P < 0.01). There were no significant differences in the rates of surgical intervention, the amount of transfusion requirements, the days of hospitalization, the deaths from bleeding and 30 d mortality between the three groups. The number of patients who developed epigastric pain due to endoscopic injection, was significantly higher in the 40 mL epinephrine group (51/76) than in the 20 (2/76) and 30 mL (5/76) epinephrine groups (P < 0.001). Significant elevation of systolic blood pressure after endoscopic injection was observed in the 40 mL epinephrine group (P < 0.01). Significant decreasing and normalization of pulse rates after endoscopic injections were observed in the 20 mL and 30 mL epinephrine groups (P < 0.01).
CONCLUSION: Injection of 30 mL diluted epinephrine (1:10000) can effectively prevent recurrent bleeding with a low rate of complications. The optimal injection volume of epinephrine for endoscopic treatment of an actively bleeding ulcer (spurting or oozing) is 30 mL.
Authors:
Tai-Cherng Liou; Shee-Chan Lin; Horng-Yuan Wang; Wen-Hsiung Chang
Related Documents :
2869208 - Controlled trial of small bipolar probe in bleeding peptic ulcers.
19824118 - Treating delayed endoscopic sphincterotomy-induced bleeding: epinephrine injection with...
22429608 - Postoperative stability following maxillary downward movement with le fort i inclined o...
19968778 - The recent reduction in mortality from bleeding oesophageal varices is primarily observ...
16729398 - Long-term follow up of diabetic patients treated with sirolimus-eluting stents. an angi...
23982408 - The detrimental effects of systemic ibuprofen delivery on tendon healing are time-depen...
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  World journal of gastroenterology : WJG     Volume:  12     ISSN:  1007-9327     ISO Abbreviation:  World J. Gastroenterol.     Publication Date:  2006 May 
Date Detail:
Created Date:  2006-05-23     Completed Date:  2006-07-18     Revised Date:  2014-09-09    
Medline Journal Info:
Nlm Unique ID:  100883448     Medline TA:  World J Gastroenterol     Country:  China    
Other Details:
Languages:  eng     Pagination:  3108-13     Citation Subset:  IM    
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Blood Pressure / physiology
Endoscopy, Gastrointestinal
Epinephrine / administration & dosage*,  adverse effects,  therapeutic use*
Female
Hemostasis / physiology
Humans
Injections / methods,  standards*
Male
Middle Aged
Peptic Ulcer Hemorrhage / drug therapy*,  physiopathology,  prevention & control
Prospective Studies
Recurrence
Vasoconstrictor Agents / administration & dosage*,  adverse effects,  therapeutic use*
Chemical
Reg. No./Substance:
0/Vasoconstrictor Agents; YKH834O4BH/Epinephrine
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Efficacy of one-day quadruple therapy for H pylori infection in Chinese patients.
Next Document:  Conversion to sirolimus immunosuppression in liver transplantation recipients with hepatocellular ca...