The comparison of intravenous pantoprazole and ranitidine in the patients who admitted to emergency department with dyspepsia depending peptic ulcer or gastritis: Randomized, double blinded, clinical trial

Dyspepsia is a common reason for admissions to emergency department and it is more important patient group in the management of emergency department. There are a few studies in the medical literature researching treatment options for dyspepsia in emergency department. Furthermore there is no study compared the efficacy of proton pump inhibitors and H2 receptor blockers for treating dyspepsia in emergency department. We aimed to compare the efficacy of proton pump inhibitors and H2 receptor blockers for treating dyspepsia in the emergency department. This prospective, randomized, controlled double blinded study was conducted in the Akdeniz University Emergency Department between October 2012 ? January 2013. Study groups were as follows: 50 mg ranitidine (Ulcuran®) in 100 ml normal saline and 40 mg pantoprazole (Pantpas®) in 100 ml normal saline, given by intravenous rapid infusion in the 2-4 minutes. The intensity of the pain was measured by VAS (Visual Analogue Scale 0mm: no pain 100 mm: more serious pain). Measurements were performed before administering the study drugs, 30th minutes and 60th minutes after the administration. Patients were blinded with all measurements. At the end of the study every side effects- nause, vomiting, allergic reactions- was reported. A total of 72 patients were eligible for the study. Two of them were excluded from the study because the initial VAS scores were under 20-mm. Four of them were excluded from the statistical analysis because of being diagnosed as the other causes of epigastric pain despite being allocated to one of the study groups. Thirty three patients in pantoprazole group and 33 patients in ranitidine group were analyzed ultimately. The mean age of the study subjects was 36.6±15 and 39.4% (n=26) of them were male. Both groups reduced pain effectively at 30th (27.6±28 (18 to 37) vs 28.3±23 (20 to 37), respectively) and 60th minutes (39.6±39 (26 to 53) vs 42.3±25 (33 to 51), respectively). There were 13 (39.4%) patients in pantoprozole group and 8 patients (24.2%) in ranitidine group who required additional drug at the end of the study (p=0.186). Nine patients (30%) in pantoprozole group and 12 patients (41.4%) ranitidine group declared to repeat of the pain (p=0.361). There was also no difference between two groups (4 (13.3%) vs 5 (17.2%), respectively, p=0.676) seeking for medical aid at 24th hours. As a conclusion, pantoprazole and ranitidine are both effective in ceasing dyspeptic symptom in emergency department at 30th and 60th minutes but none of them are superior to each other