title: A randomized controlled trial of adding intravenous pantoprazole to conventional treatment for the immediate relief of dyspeptic pain.
abstract: BACKGROUND
  Acute, severe dyspeptic pain is a common condition in the emergency department. Despite the traditional "GI cocktail" (GI indicates gastrointestinal), an intravenous (IV) proton pump inhibitor (PPI), a novel acid-lowering drug, has recently been used to treat this condition. The aim of this study was to evaluate the immediate effect of IV pantoprazole in addition to the conventional GI cocktail in the relief of severe dyspeptic pain.
  
  
  METHODS
  This double-blind, randomized, controlled study was conducted in the emergency department of an urban tertiary-care hospital from January 2011 to October 2011. Selected patients with severe dyspeptic pain were randomized to treatment with a placebo, antacid, and antispasmodic (conventional group) or IV pantoprazole, antacid, and antispasmodic (pantoprazole group). The self-reported 100-mm visual analog scale score, adverse effects, and overall satisfaction were evaluated in 15-minute intervals for 60 minutes.
  
  
  RESULTS
  Eighty-seven eligible cases were enrolled in the study. Forty-four and 43 patients were randomized in the conventional group and pantoprazole group, respectively. There was no difference in the mean 60-minute visual analog scale scores between the treatment groups. The rate of "responders," additional drug use, adverse effects, and patient satisfaction were similar between the groups.
  
  
  CONCLUSIONS
  Intravenous PPI provides no additional benefit over the conventional GI cocktail in the relief of acute, severe dyspeptic pain. Because of its neutral effect and higher cost, the use of IV PPI to treat such conditions should be discouraged in general clinical practice.
authors.affiliation: Emergency Medicine Unit, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok 10330, Thailand. kmusikatavorn@yahoo.com
authors.forename: Khrongwong
authors.initials: K
authors.lastname: Musikatavorn
authors.forename: Ploykaew
authors.initials: P
authors.lastname: Tansangngam
authors.forename: Suthaporn
authors.initials: S
authors.lastname: Lumlertgul
authors.forename: Atthasit
authors.initials: A
authors.lastname: Komindr
mesh_terms: D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000008:administration & dosage / Q000627:therapeutic use*; D059787:Acute Pain / Q000188:drug therapy / Q000209:etiology; D000328:Adult; D000897:Anti-Ulcer Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D004311:Double-Blind Method; D004415:Dyspepsia / Q000150:complications / Q000188:drug therapy*; D004636:Emergency Service, Hospital; D006356:Heartburn / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D000077402:Pantoprazole
chemical_list: D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000897:Anti-Ulcer Agents; D000077402:Pantoprazole