Nayab Haider, Muhamamd Azam, Khalid Mahmud, Azeem Taj.
Effect of Propranolol on portal hemodynamics in Cirrhotic patients
Pak Postgrad Med J Mar 2000;11(1):1-4.
Postgraduate Medical Institute, Lahore

A total number of 50 patients with cirrhotic portal hypertension were included in the study. After clinical examination and laboratory investigations Child`s grading of the patients was done. Five patients fell into grade - A, 39 into grade B and 6 into grade C. The patients were given propranolol in a dose sufficient to reduce their base line pulse rate by 25%. Portal flow velocity N4-as assessed before the start of propranolol with Doppler utrasonography and one month after the onset of treatment. It was found that 100% of the patients in grade A, almost 85% of the patients in grade B and 50% of the patients in grade C had a fall in portal flow velocity ranging form 5%` to 20% of the initial flow velocity. This fall in flow velocity is associated with a reduction in portal hypertension. Since high portal pressure in cirrhotic patients is associated with a high risk of gastrointestinal bleeding which carries a grave morbidity and mortality, it is recommended that every patient with cirrhotic portal hypertension should be given portal pressure lowering medical therapy in the form of propranolol, provided that there is no contraindication to its use, so that the chances of variceal bleeding can be minimized. Continuation of therapy beyond one month may further reduce the portal pressure thereby decreasing the chances of complications of portal hypertension.

Category: Internal Medicine
Keywords: Cirrhosis. Propranolol. Portal Hypertension. Hepatitis.

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