Comparison of intravenous pantoprazole and ranitidine in patients with dyspepsia presented to the emergency department: a randomized, double blind, controlled trial

Abstract

BACKGROUND:This study aimed to compare pantoprazole, a proton-pomp inhibitors (PPIs), and ranitidine, a H 2 receptor antagonists (H 2 RA), in ceasing dyspeptic symptoms in the emergency department (ED). METHODS:This randomized, double-blinded study compared the effectiveness of 50 mg ranitidine (Ulcuran ® ) and 40 mg pantoprazole (Pantpas ® ), given in a 100 mL saline solution by an intravenous rapid infusion within 2-4 minutes in patients with dyspepsia presented to the ED. Pain intensity was measured at baseline, 30 and 60 minutes after the drug administration.RESULTS: A total of 72 patients were eligible for the study. Of these patients, 2 were excluded from the study because the initial visual analogue scale (VAS) scores were under 20 mm and 4 were excluded from the statistical analysis because of being diagnosed as having other causes of epigastric pain despite being allocated to one of the study groups. Thirty-three patients in the pantoprazole group and 33 patients in the ranitidine group were analyzed ultimately. The mean age of the patients was 36.6±15 years, and 26 (39.4%) patients were male. Both of the groups reduced pain effectively at 30 [27.6±28 (18 to 37) vs. 28.3±23 (20 to 37), respectively] and 60 minutes [39.6±39 (26 to 53) vs. 42.3±25 (33 to 51), respectively]. There were 13 (39.4%) patients in the pantoprazole group and 8 (24.2%) patients in the ranitidine group who required additional drug at the end of the study (P=0.186).CONCLUSION: Intravenous pantoprazole and ranitidine are not superior to each other in ceasing dyspeptic symptoms at 30 and 60 minutes in the ED.

Design characteristics of comparative effectiveness trials for the relief of symptomatic dyspepsia: A systematic review

“…Participants were recruited from patient visit to hospital (n = 28), 31 , 32 , 34 , 35 , 36 , 37 , 38 , 40 , 41 , 42 , 43 , 44 , 45 , 47 , 48 , 49 , 50 , 51 , 52 , 55 – 60 , 64 , 65 , 67 medical college (n = 2) 51 , 53 or specialist community based clinic (n = 13) 32 , 34 , 36 , 39 , 40 , 44 , 46 , 49 , 50 , 52 , 63 , 64 , 66 or both. Method of recruitment; unspecified (n = 15), 32 , 33 , 36 , 40 , 42 , 43 , 44 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 63 invitation (n = 6), 37 , 38 , 39 , 41 , 53 , 65 advertising (n = 3), 35 , 37 , 56 consecutive patients presenting for care (n = 3)…”

“…Method of delivery was presented as usual care with a structured protocol for dose, duration and frequency of intervention (n = 26). 31 , 32 , 33 , 34 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 46 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 63 – 67 A wash-out period was required in ten studies. 31 , 32 , 33 , 34 , 36 , 44 , 54 , 55 , 56 , 60 One study described flexibility in selection of acupuncture points for the individual.…”