Indomethacin intravenously--a new way for effective relief of biliary pain: a double-blind study in man

Abstract

Prostaglandins have been demonstrated to contract the gallbladder and induce fluid secretion into its lumen in experimental animals. Indomethacin is an effective inhibitor of prostaglandin synthetase and has recently been demonstrated to inhibit inflammatory fluid secretion into the gallbladder in experimental cholecystitis. A mechanism by which an increased prostaglandin synthesis will result in a raised intraluminal pressure in the gallbladder in patients with gallstone disease has been suggested. By inhibiting the synthesis of prostaglandins with indomethacin the intraluminal pressure is reduced and the biliary pain relieved. In a double-blind study with a placebo in 40 separate attacks of biliary pain in 37 patients with verified gallstone disease intravenous indomethacin was found to effectively relieve pain within 5 to 30 minutes. No serious side effects were seen, but nausea and vertigo of short duration were noticed in 10 of 21 cases of indomethacin treatment. The drug did not affect blood pressure, but a reduction of the pulse rate was usually seen.