Comparison of Low Versus Standard Dose Intravenous Diazepam for Alcohol Withdrawal Prophylaxis in Alcohol Dependent Patients Who Present with Upper Gastrointestinal Bleeding

Abstract

Objective: To compare low dose with standard dose intravenous diazepam for prevention of alcohol withdrawal symptoms in alcohol dependent patients who present with upper gastrointestinal bleeding (UGIB). Material and Methods: A prospective randomized controlled trial was conducted at Hatyai Hospital. Two different doses of intravenous diazepam were randomly given to eligibility criteria (2.5 mg VS 5 mg) every 6 hours. The treatment followed the standard protocol approved by the Ethics Committee of Hatyai Hospital. Demographic data, treatment outcome, complications and length of stay were compared. Results: Sixty eight alcohol dependent patients with UGIB were enrolled in the study. There were 31 patients (45.5%) who received intravenous diazepam 2.5 mg every 6 hours (low dose group) while 37 patients ( 54.4%) received intravenous diazepam 5 mg every 6 hours (standard dose group). The total number of patients with alcohol withdrawal symptoms was 14 (20.6%), [5 in the low dose group and 9 in the standard dose group (p-value=0.4)]. One patient in the low dose group, and 2 patients in the standard dose group did not receive the full dose because of drowsiness. Conclusion: There was no significant difference in the number of patients who experienced alcohol withdrawal symptoms between the two group. However, patients who received low dose intravenous diazepam had fewer side effects.

Keywords

• alcohol withdrawal symptom
• diazepam
• prevention
• upper gi bleeding