Propranolol in Prevention of Rebleeding from Oesophageal Varices during the Course of Endoscopic Sclerotherapy

Abstract

Thirty-one patients admitted with the first bleeding episode from oesophageal varices were randomized in a double-blind manner to receive oral propranolol, 160 mg daily, for 6 months (n = 15) or matching placebo (n = 16) for the same period. Endoscopy was performed each month during the 6 months and additionally after a further 3 months. The oesophageal varices were injected paravariceally with 2% aethoxysclerol until obliteration. If rebleeding occurred, additional sclerotherapy was performed. In the group treated with sclerotherapy and propranolol 3 patients rebled (20%; 95% confidence limits, 4%-48%), whereas 12 patients treated with sclerotherapy and placebo rebled (75%; 95% confidence limits, 48%-93%; p < 0.05). There were no side effects to treatment in either of the groups, and it is concluded that administration of propranolol reduces the frequency of variceal rebleeding before variceal obliteration during a course of endoscopic sclerotherapy.

Key Words:

• Oesophageal varices
• propranolol
• sclerotherapy