The present double-blind study was aimed at investigating the hemodynamic and humoral effects of somatostatin or placebo in patients with cirrhosis. Patients were randomly assigned to receive either an injection of 250 pg of somatostatin followed by a constant infusion of somatostatin at 250 pg/h (n = 13), an injection of 250 pg of somatostatin followed by a 500 pg/h continuous infusion (n = lo), or an injection of placebo followed by a placebo infusion (n = 9). Placebo had no effect. Somatostatin bolus markedly decreased the hepatic venous pressure gradient: by 52% at 1 minute; P < .001; 19% at 3 minutes, P < .01; and by 13% at 5 minutes, P < .04.
Azygos blood flow decreased similarly by 45% at 1 minute, P < .001; 16% at 3 minutes, P < .02; and 9.5% at 5 minutes, P = .05. Mean arterial pressure increased by 25% (P < .001). Continuous somatostatin infusions (250 or 500 pg/h) had no systemic effects, but significantly reduced hepatic venous pressure gradient (250 pgk: -6.1%, P < .05 and 500 pg/h: -15%, P < .01) and hepatic Azygos blood flow was not changed after 250 pg/h infusion but was reduced after 500 pg/h (-23%, P < .02).
Somatostatin but not placebo, suppressed glucagon to normal levels. This study shows that a bolus injection of somatostatin caused an immediate and marked decrease of hepatic venous pressure gradient and azygos blood flow. Continuous infusion of somatostatin had a mild but sustained effect on splanchnic hemodynamics; this effect was more pronounced with the higher dose. (IHEP-blood flow (250 pglh: -lo%, 500 pg/h: -18%, P < .05).