The hemostatic action of pitressin and scopolamine butyl bromide to the gastrointestinal hemorrhage, especially bleeding esophageal varices was investigated both experimentally and clinically.
These agents were administered intravenously in dogs, and their effects on the arterial and venous bleeding were observed. Arterial pressure (AP), portal vein pressure (PP), hepatic vein pressure (HVP), splenic vein pressure (SVP), splenic volume (SV) and hepatic blood flow (HBF) were measured before and after the administration of these agents.
In rats, blood capillaries on the surface of the liver and of the intestine were examined by a biomicroscope to evaluate the effects of these drugs.
Effects of these agents for the bleeding esophageal varices of the cirrhotic patients were also studied.
The results would be summarized as following:
1) Pitressin
In dogs, after the intravenous administration of 20 units of pitressin, AP was elevated, PP, HVP and SVP decreased and HBF was reduced. Decreased arterial bleeding was observed in 5 dogs out of 7, and that of venoud bleeding in four out of five dogs. In rats, contraction of the arterioles on the surface of the liver and intestine was confirmed. Pitressin induces a marked contraction of the arterioles which increases the peripheral vascular resistance, and as the result circulating blood flow in the portal system reduces. Thus the gastrointestinal bleeding becomes suspended. In our experience, temporary hemostatic effect on the esophageal bleeding was revealed in seven cases out of twelve.
2) Scopolamine butyl bromide
Intravenous administration of 20mg. of scopolamine butyl bromide in dogs induced a drop of AP, PP, HVP and SVP; there was also decrease of hepatic blood flow. Arterial and venous bleeding was reduced remarkably. Capillaries on the surface of the liver and intestine of rats were slightly dilated.
The main effect of this agent is presumably the hemostatic action resulting from the decrease in the blood flow velocity in the portal vein and a drop of the pressure in the blood vessels of the entrails.
The author used this agent for gastrointestinal hemorrhage and satisfactory effects were revealed in eight cases out of eleven.
3) Noradrenaline
Elevation of AP, PP and SVP and decrease of HVF was conspicuous in dogs after intravenous injection of 0.2mg of noradrenaline. This reinforced the bleeding from arteries and veins. Distinct contraction of capillaries by this agent was observed on the surface of the liver and intestinal tract in rats.
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