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Optimal injection volume of epinephrine for endoscopic prevention of recurrent peptic ulcer bleeding.

Abstract：

BACKGROUND:Although the initial rate of hemostasis achieved by endoscopic epinephrine injection for peptic ulcer bleeding is high, bleeding recurs in 14.6% to 35.5% of patients. The aim of this study was to compare rates of recurrent bleeding after endoscopic injection of two different volumes of epinephrine in patients with peptic ulcer bleeding. METHODS:A total of 72 patients with peptic ulcer with active bleeding or a non-bleeding visible vessel were randomly assigned to 15 to 25 mL or 35 to 45 mL injections of a 1:10,000 solution of epinephrine. RESULTS:The two groups were similar with respect to all background variables. The mean volume of epinephrine injected was 19.4 mL: 95% CI [18.7, 20.1] in the 15 to 25 mL group and 41.1 mL: 95% CI [40.0, 42.2] in the 35 to 45 mL group. Initial hemostasis was achieved in 35 of 36 patients (97.2%) in the 15 to 25 mL group and in all 36 patients in the 35 to 45 mL group. The 35 to 45 mL volume was significantly more effective in preventing recurrent bleeding than the 15 to 25 mL volume (0% vs. 17.1%; p < 0.05). For ulcers in the gastric body, the 35 to 45 mL volume was significantly more effective in preventing recurrent bleeding than the 15 to 25 mL volume (0% vs. 31.6%; p = 0.003). For ulcers in other locations, including the gastric antrum and the duodenum, there were no significant differences in the rate of recurrent bleeding between the two groups. CONCLUSIONS:Injection of 35 to 45 mL of a 1:10,000 solution of epinephrine is more effective than injection of 15 to 25 mL of the same solution for prevention of recurrent bleeding from ulcers in the body of the stomach.

journal_name

Gastrointest Endosc

journal_title

Gastrointestinal endoscopy

authors

Park CH,Lee SJ,Park JH,Park JH,Lee WS,Joo YE,Kim HS,Choi SK,Rew JS,Kim SJ

doi

10.1016/s0016-5107(04)02279-5

keywords:

subject

Has Abstract

pub_date

2004-12-01 00:00:00

pages

875-80

issue

6

eissn

0016-5107

issn

1097-6779

pii

S0016-5107(04)02279-5

journal_volume

60

pub_type

临床试验,杂志文章,随机对照试验

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