title: Immediate effects of different schedules of somatostatin on portal pressure in patients with liver cirrhosis.
abstract: OBJECTIVE
  Somatostatin (SST) is used for the treatment of acute variceal bleeding based on its ability to decrease portal pressure and collateral blood flow. To date, no studies have focused on the immediate-early effects (between 1 and 30 min) of SST. The aim of this study was to compare the efficacy of different schedules of SST therapy with placebo on portal pressure in patients with portal hypertension treated with portal-azygous disconnection and to test whether an increase in bolus or infusion dose can improve the clinical efficacy of SST therapy.
  
  
  METHODS
  Patients were treated with four different schedules: (a) standard dose (n = 11): one 250 μg bolus + a continuous infusion of 250 μg/h; (b) medium dose (n = 10): 500 μg bolus + a continuous infusion of 250 μg/h; (c) high dose (n = 10): 250 μg bolus + a continuous infusion of 500 μg/h; (d) control (n = 10): an injection of placebo (saline) followed by a placebo infusion. Following SST or placebo administration, portal pressure, central venous pressure (CVP), systemic blood pressure and heart rate (HR) were measured at 1, 3, 5, 7, 10 and 30 min.
  
  
  CONCLUSIONS
  The three schedules of SST induced a marked, rapid and highly significant decrease in portal pressure. The decline in portal pressure was moderate at 1 min (P < 0·040), achieved a peak effect at 5 min (P < 0·009) and remained decreased at 30 min. The effect of SST on portal pressure was significantly greater than placebo from 1 min after administration. There were no significant differences in portal pressure decrease between the three schedules of SST. The three schedules of SST and the placebo schedule did not induce significant changes in HR, systemic blood pressure and CVP.
  
  
  CONCLUSIONS
  This study shows that SST is effective in decreasing portal pressure within 30 min of administration in patients with liver cirrhosis. The clinical schedule used in this study was reasonable and safe.
authors: Department of Surgery, Anhui Geriatric Institute, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
authors: C
authors: C
authors: Zhang
authors: J-M
authors: JM
authors: Xu
authors: D-R
authors: DR
authors: Kong
authors: X-K
authors: XK
authors: Min
authors: R
authors: R
authors: Chen
mesh_terms: D000328:Adult; D002496:Central Venous Pressure / Q000187:drug effects*; D004334:Drug Administration Schedule; D005260:Female; D006339:Heart Rate / Q000187:drug effects*; D006728:Hormones / Q000008:administration & dosage; D006801:Humans; D006975:Hypertension, Portal / Q000188:drug therapy* / Q000503:physiopathology; D008103:Liver Cirrhosis / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D017082:Portal Pressure / Q000187:drug effects*; D013004:Somatostatin / Q000008:administration & dosage*
chemical_list: D006728:Hormones; D013004:Somatostatin