Omeprazole versus ranitidine as adjunct therapy to endoscopic injection in actively bleeding ulcers: a prospective and randomized study.
Endoscopy
; 27(4): 308-12, 1995 May.
Article
em En
| MEDLINE
| ID: mdl-7555936
ABSTRACT
BACKGROUND AND STUDY AIMS:
Although high rates of initial hemostasis can be achieved with endoscopic injection therapy in actively bleeding ulcers, the incidence of rebleeding is not negligible. Optimal conditions for clotting may require achieving deep and sustained acid inhibition to avoid the deleterious effect of acid and pepsin secretions on the hemostatic process. The aim of this study was to assess whether omeprazole could improve the efficacy of ranitidine as an adjunct treatment in endoscopic injection therapy to avoid rebleeding. PATIENTS ANDMETHODS:
Eighty-six patients with active arterial bleeding from a peptic ulcer disclosed at emergency endoscopy were included in this prospective trial. All patients received injections of 110,000 adrenaline. Subsequently, they were randomized to receive either intravenous omeprazole (n = 45), with an initial dose of 80 mg followed by 40 mg every eight hours for four days and thereafter with oral administration; or ranitidine (n = 41), 50 mg every six hours for 12 to 24 hours and thereafter with oral administration.RESULTS:
The two groups were well matched in terms of clinical and endoscopic data. There were no statistically significant differences between the groups with regard to further bleeding (29% in both groups), need for emergency surgery (20% in the omeprazole group vs. 22% in the ranitidine group), transfusion requirements (2.4 +/- 2.2 vs. 2.2 +/- 2.1 units), length of hospital stay (14.1 +/- 13.9 vs. 15.3 +/- 15.4 days), or mortality (7% vs. 2%).CONCLUSIONS:
Our results suggest that omeprazole does not improve the efficacy of ranitidine after endoscopic injection therapy in patients with an active arterial bleeding ulcer.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Ranitidina
/
Úlcera Gástrica
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Omeprazol
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Úlcera Péptica Hemorrágica
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Hemostase Endoscópica
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Úlcera Duodenal
/
Antiulcerosos
Tipo de estudo:
Clinical_trials
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Diagnostic_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
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Female
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Humans
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Male
/
Middle aged
Idioma:
En
Ano de publicação:
1995
Tipo de documento:
Article