Comparison of Somatostatin and Famotidine for the Treatment of Nonvariceal Acute Upper Gastrointestinal Bleeding
Journal Title: International Journal of Current Research and Review - Year 2018, Vol 10, Issue 8
Abstract
Introduction: It is aimed to be researched if somatostatin is as effective as H2 blockers to stop the bleeding in centres where the endoscopic treatment is not available for the non-variceal upper GI bleeding cases Methods: The patients who were admitted to the Department of Internal Medicine of Dicle University with the diagnosis of upper GI bleeding, and were not suitable for endoscopic treatment are subjected in our paper. One group was given 250 mcg bolus dose of somatostatin followed by 120 hours of infusion at a speed of 250 mcg/hour whereas the other group was given 20 mg intravenous famotidine every 12 hours. The amount of time required to stop bleeding, the amount of blood transfusion made during that 120 hours time period, the ratio of recurrent bleeding, and the ratio of the necessity of surgical intervention were noted. Results: 42 patients were included in the study. 21 patients were in somatostatin group, and the other 21 patients were in H2 receptor blocker group. In both somatostatin and H2 receptor blockers groups, the cause of gastrointestinal bleeding was found to be duodenal ulcers in 71% of the patients and gastric ulcer in 14% of the patients. While bleeding had stopped in the first 48 hours in 95.2% of the patients in somatostatin group, the same thing happened in 90.4% of the patients in H2 receptor group. There were no statistical difference between the two groups (p=0.90). The average time passed to stop the bleeding was 15 hours (6-24 hours) for the somatostatin group, whereas it was 34 hours (6-72 hours) for the H2 receptor blocker group. Somatostatin stopped the bleeding in a shorter time which was statistically significant (P=0.01).while the required blood transfusion amount was an average of 3.5 (0-13) units for the somatostatin group, it was 4.4 (0-14) units for the group of H2 receptor blocker. There were no statistically significant difference (p=0.182). The surgical intervention was needed in 9.6% of the patients in somatostatin group, whereas it was needed in 14.2% of the patients in H2 receptor group (p=0.212). Conclusion: While somatostatin statistically significantly stops the bleeding in a shorter time period as compared with H2 receptor blockers, no significant difference in blood transfusion requirement and surgical necessity were detected. Cost-effectiveness of somatostatin should be considered when it is used in GI bleeding cases.
Authors and Affiliations
Caglayan Geredeli
Keywords
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- EP ID EP542598
- DOI 10.7324/IJCRR.2018.10805
- Views 104
- Downloads 0
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