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Double‐blind investigation of the effects of propranolol and placebo on the pressure of esophageal varices in patients with portal hypertension
Author(s) -
Feu Faust,
Bordas Josep M.,
GarciaPagán Joan C.,
Bosch Jaime,
Rodés Joan
Publication year - 1991
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.1840130519
Subject(s) - placebo , propranolol , medicine , esophageal varices , portal hypertension , blood pressure , varices , portal venous pressure , saline , gastroenterology , esophagus , anesthesia , cirrhosis , pathology , alternative medicine
This study was aimed at investigating the effects of propranolol on esophageal variceal pressure in patients with portal hypertension. Variceal pressure was measured at endoscopy using a miniature pressure‐sensitive gauge in 20 patients with portal hypertension. Measurements were obtained under baseline conditions and 20 min after double‐blind administration of propranolol (0.15 mg/kg; n = 10) or an identical amount of placebo (normal saline, 0.3 ml/kg; n = 10). Under baseline conditions, variceal pressure was similar in propranolol and placebo groups (14.1 ± 5 mm Hg vs. 14.9 ± 6.6 mm Hg, respectively; not significant). Placebo had no significant effect on variceal pressure (baseline = 14.9 ± 6.6 mm Hg; placebo = 15.5 ± 6.6 mm Hg; not significant), and values after placebo administration were closely correlated with baseline values (r = 0.98; y = 1.1 + 0.97 x; p < 0.0001). In contrast, propranolol caused a significant decrease in the pressure of esophageal varices (from 14.1 ± 5 mm Hg to 11.3 ± 4.4 mm Hg; p < 0.002). No significant changes in the size of esophageal varices were observed after propranolol or placebo administration. This study shows (a) the endoscopic pressure‐gauge technique has a low variability and may be used to assess acute drug‐induced changes in variceal pressure; and (b) propranolol causes significant decreases in variceal pressure in patients with portal hypertension and esophageal varices. (H EPATOLOGY 1991;13:917–922.)