Use Of Intravenous Glucagon Research Articles

Does routine intravenous glucagon administration facilitate colonoscopy? A randomized trial

Background: Previous studies on the routine use of glucagon in colonoscopy have produced conflicting results.Methods: Two separate studies were performed. In one study (Study 1), 80 consecutive patients were randomized after cecal intubation to receive 1 mg glucagon ( n = 41) or placebo ( n = 39), intravenously, in double-blind fashion. In a second study (Study 2) 90 sedated patients undergoing colonoscopy were randomized to receive 1 mg glucagon ( n = 46) or placebo ( n = 44), intravenously, just before colonoscope insertion. In each study, colonoscope insertion and withdrawal time, therapeutic intervention time, the presence and severity of colonic spasm, colonoscopy yield, and side effects were recorded.Results: Mean withdrawal time in Study 1 was similar in those receiving glucagon (6.85 min) and in those receiving placebo (6.92 min). Mean insertion time in Study 2 (5.07 min) was identical between groups. Spasm scores and colonoscopy yield did not differ between glucagon and placebo in either study. There was a trend toward more side effects (nausea and vomiting) with glucagon in Study 1. Glucagon did not facilitate insertion or withdrawal in the subset of patients with diverticulosis.Conclusions: Routine use of intravenous glucagon in a dosage of 1 mg does not facilitate colonoscopy by experienced examiners. (Gastrointest Endosc 1995;42:346-50.)

Computed tomographic air enema technique to demonstrate colonic neoplasms

The use of intravenous glucagon and the judicious introduction of air into a clean colon offer additional help in the confirmation of the larger intracolonic tumors on computed tomographic examination. The procedure is simple and may aid in the differentiation of an intrinsic colonic tumor from other pathologic conditions, particularly those that are extracolonic in origin.

Propranolol toxicity and the use of intravenous glucagon in the dog model

Propranolol toxicity and the use of intravenous glucagon in the dog model

Esophageal food impaction: treatment with glucagon.

Nineteen patients who had foreign bodies in the distal esophagus were examined prospectively to determine the efficacy of intravenous glucagon in relieving the obstruction. The administration of glucagon resulted in clearance of the impacted food in seven patients. Although the success rate is relatively low, the risk is minimal and justifiable. Use of intravenous glucagon is a safe, worthwhile initial step in the treatment of distal esophageal foreign bodies.

Intravenous glucagon in the management of esophageal food obstruction

The use of intravenous glucagon in patients with obstructing esophageal food impaction of at least 24-hours duration has recently been described. Two cases of acute esophageal obstruction were relieved within ten minutes by intravenous infusion of 1 mg of glucagon. Esophagram performed both before and after glucagon administration confirmed the original obstruction and the passage of the food bolus. Therapy for bolus obstruction of the esophagus has classically included proteolytic enzyme digestion, as well as esophagoscopy with manual extraction. Each entails risk of esophageal perforation and mediastinitis. Also, the dose of proteolytic enzymes, such as papain, may take several hours to administer while endoscopic examination is generally not feasible as an outpatient emergency procedure. Intravenous glucagon can dissolve food other than meat and has the further advantage of safety in the patient in which anticholinergics, another occasionally employed therapy, are contraindicated. A protocol for management of these patients is included.

Glucagon as a hypotonic agent in cholangiography

The effects of Glucagon on 35 cholangiographic studies was examined. Relief of spasm at the choledochoduodenal sphincter resulted in consistently improved demonstration of this area. Diminished spasm-induced pain was also recorded. The use of intravenous Glucagon is recommended for cholangiographic studies where there is total biliary obstruction, or where there is unsatisfactory demonstration of the choledocho-duodenal area.

Postoperative treatment of patients after liver resection for trauma: a follow-up study.

In the last ten years, 89 hepatic resections were performed for trauma. Thirty-three patients survived and were followed up for one month to seven years: 15 patients had right lobectomy, nine left lobectomy, and nine left lateral segmentectomy. Complications were primarily pulmonary. All patients had transient derangement of liver function tests, but only three patients had liver dysfunction. Long-term follow-up showed no ill effects from the liver resection. Important postoperative treatment includes (1) adequate dependent drainage, (2) maintenance of blood volume, (3) intravenous albumin and glucose, (4) adequate nutritional support, and (5) selective use of intravenous glucagon.