A group of researchers from Taiwan compared the effects of endoscopic injection with fibrin sealant versus epinephrine for the arrest of peptic ulcer bleeding.
Between December 1998 and July 2000, 51 patients with active bleeding or nonbleeding visible vessels entered the trial.
The clinical parameters were comparable between both groups.
In the epinephrine group (n = 25), the investigators injected 5 to 10 ml of 1:10,000 epinephrine, surrounding the bleeder.
In the fibrin sealant group (n = 26), 4 ml of fibrin sealant was injected, surrounding the bleeder.
| Rebleeding almost 4-times more likely in epinephrine group than in fibrin sealant group.
| Journal of Clinical Gastroenterology |
Initial hemostasis was obtained in all enrolled patients.
Rebleeding was more common in the epinephrine group than in the fibrin sealant group (56% vs 15% on the intention-to-treat basis, and 58% vs 17% on the per protocol basis, respectively).
Volume of blood transfusion, number of surgeries, hospital stay, and number of deaths were similar between both groups.
Dr Hwai-Jeng Lin, from Taipei, Taiwan, concluded on behalf of fellow colleagues, "Fibrin sealant injection is more effective in preventing rebleeding than epinephrine after endoscopic therapy.
"However, this study showed no difference in outcomes with either therapy."