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Use of propranolol to reduce the rebleeding rate during injection sclerotherapy prior to variceal obliteration
Author(s) -
Westaby David,
Melia Walter,
Hegarty John,
Gimson Alexander E. S.,
Stellon Anthony J.,
Williams Roger
Publication year - 1986
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.1840060422
Subject(s) - medicine , sclerotherapy , propranolol , varices , cirrhosis , resuscitation , portal hypertension , varix , randomized controlled trial , anesthesia , hepatic encephalopathy , surgery
In a prospective, randomized controlled trial, 53 patients with variceal hemorrhage from portal hypertension, including 44 with cirrhosis, were allocated, after initial control of the bleeding, to treatment by sclerotherapy alone, or by this together with oral propranolol in a dose sufficient to reduce resting pulse rate by 25% during the period up to the time when varices were obliterated. Eight of the 27 patients undergoing sclerotherapy alone rebled during this period as compared to 7 of the 26 patients in the additional propranolol group (p > 0.80), two patients from each group dying from uncontrollable variceal hemorrhage. Propranolol precipitated encephalopathy in one patient and complicated resuscitation following bleeding in a second, and as there was no evidence in this study that use of the drug reduced the frequency or severity of the variceal bleeding, its administration cannot be recommended during the period prior to obliteration of varices by sclerotherapy.