A prospective randomized controlled trial of sandostatin and vasopressin in the management of acute bleeding esophageal varices.
To study the hemostatic effect of Sandostatin, a long-acting analogue of somatostatin, in acute variceal bleeding, a prospective randomized controlled trial comparing it with Vasopressin was conducted in 41 cirrhotic patients with esophageal variceal bleeding. Initial hemostasis was achieved within 6 hours in 75% of patients treated with Sandostatin and in 61.9% treated with Vasopressin. Recurrent bleed developed in 20% of patients in Sandostatin group and 46.2% in Vasopressin group following initial hemostasis. Complete control of bleeding for 24 hours was attained in 60% of the Sandostatin group and in 33.3% of the Vasopressin group. There was no statistically significant difference in both the rate of initial hemostasis and complete bleeding control. Hospital mortality was also similar in both groups. However, transfusion requirements were less (P less than 0.05) and side effects tended to be milder in patients treated with Sandostatin. In conclusion, Sandostatin is at least as effective as Vasopressin in the treatment of acute variceal bleeding, and carries less severe complications than Vasopressin does.
Huang
C C
CC
Department of Hepato-Gastroenterology, Chang Gung Memorial Hospital, Taipei, Taiwan, R.O.C.
Sheen
I S
IS
Chu
C M
CM
Chuah
S K
SK
Chien
R N
RN
Peng
S M
SM
Kuo
Y C
YC
Lin
S M
SM
Lin
D Y
DY
Chen
P C
PC
D000328:Adult; D000368:Aged; D004932:Esophageal and Gastric Varices / Q000188:drug therapy*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000627:therapeutic use*; D011446:Prospective Studies; D014667:Vasopressins / Q000627:therapeutic use*
D014667:Vasopressins; D015282:Octreotide